Capsular Thickness Research Articles

Microaerobic-mediated suppression of Klebsiella pneumoniae mucoviscosity is restored by rmpD overexpression.

Hypervirulent Klebsiella pneumoniae (hvKp) causes invasive community-acquired infections in healthy individuals, and hypermucoviscosity (HMV) is the main phenotype associated with hvKp. This study investigates the impact of microaerobic environment availability on the mucoviscosity of K. pneumoniae. By culturing 25 clinical strains under microaerobic and aerobic environments, we observed a notable reduction in mucoviscosity in microaerobic environments. RNA sequencing and qRT-PCR revealed downregulated expressions of capsule synthesis genes (galf, orf2, wzi, wza, wzb, wzc, wcaj, manC, manB, and ugd) and regulatory genes (rmpA, rmpD, and rmpC) under microaerobic conditions. Transmission electron microscopy and Indian ink staining analysis were performed, revealing that the capsular thickness of K. pneumoniae decreased by half in microaerobic conditions compared to aerobic conditions. Deletion of rmpD and rmpC caused the loss of the HMV phenotype in both aerobic and microaerobic conditions. However, compared to wild-type strain in microaerobic condition, only rmpD overexpression strain, and not rmpC overexpression strain, displayed a significant increase in capsule thickness in microaerobic conditions. Microaerobic conditions can suppress the mucoviscosity of K. pneumoniae, but this suppression can be overcome by altering the expression of rmpD, indicating a specific function for rmpD in the oxygen environmental adaptation of K. pneumoniae.

Influence of the agrochemical benomyl on Cryptococcus gattii-plant interaction in vitro and in vivo.

Cryptococcus gattii, an environmental fungus, is one of the agents of cryptococcosis. The influence of agrochemicals on fungal resistance to antifungals is widely discussed. However, the effects of benomyl (BEN) on fungal interaction with different hosts is still to be understood. Here we studied the influence of adaptation to BEN in the interaction with a plant model, phagocytes and with Tenebrio molitor. First, the strain C. gattii L24/01 non-adapted (NA), adapted (A) to BEN, and adapted with further culture on drug-free media (10p) interact with Nicotiana benthamiana, with a peak in the yeast burden on the 7th day post-inoculation. C. gattii L24/01 A and 10p provided lower fungal burden, but these strains increased cell diameter and capsular thickness after the interaction, together with decreased fungal growth. The strains NA and A showed reduced ergosterol levels, while 10p exhibited increased activity of laccase and urease. L24/01 A recovered from N. benthamiana was less engulfed by murine macrophages, with lower production of reactive oxygen species. This phenotype was accompanied by increased ability of this strain to grow inside macrophages. Otherwise, L24/01 A showed reduced virulence in the T. molitor larvae model. Here, we demonstrate that the exposure to BEN, and interaction with plants interfere in the morphophysiology and virulence of the C. gattii.

A comparison of conventional 3.0-Tesla nonenhanced magnetic resonance imaging and arthroscopic findings of the anteroinferior capsulolabral complex in patients with traumatic anterior shoulder instability

This study aimed to evaluate the association between specific, reproducible findings of an anteroinferior capsulolabral complex obtained using conventional 3.0-Tesla nonenhanced magnetic resonance imaging (MRI) and pathologic arthroscopic findings and to assess the confidence level of the findings. Of 125 cases of traumatic anterior instability surgery from January 2017 to November 2019, 66 patients (52 men, 14 women; 23.5±7.9 year old) who underwent conventional 3.0-Tesla MRI at our hospital were reviewed. The following anteroinferior capsulolabral complex features were observed on the T2-star axial image: size difference of the labrum (swelling, diminished), difference in marginal and internal signals (irregularity), and capsule edema image (capsular thickening). We also reviewed fraying, flattening, cracking, and capsular hypertrophy as pathologic arthroscopic findings of the capsulolabral complex. These findings allowed for the simultaneous description of the MRI and arthroscopic evaluations. Three orthopedic surgeons and one radiologist measured the interobserver reliability. We investigated the correlation between the MRI and arthroscopic findings. The interobserver reliability of MRI irregularities was low (κ=-0.16), whereas reliability was moderate (κ=0.554-0.595) for swelling in 22 cases (33%), diminished in 34 cases (52%), and capsular thickness in 40 cases (59%). Labral detachment was found in 26 patients (39%) and fluid collection in 24 patients (36%). The agreement of MRI findings with arthroscopic findings was κ=0.46 (95% confidence interval [CI]: 0.268-0.654) for swelling to fraying; κ=0.42 (95% CI: 0.202-0.638) for swelling to capsular hypertrophy; and 0.46 (95% CI: 0.268-0.654) for flattening to diminished. The swelling and diminished findings of the anteroinferior capsulolabral complex on conventional MRI were moderately related to pathologic arthroscopic findings in patients with traumatic anterior shoulder instability. These findings contribute to achieving an accurate clinical diagnosis.

Dysplastic Hips Have Decreased Iliofemoral Ligament Thickness on Coronal Sequences in Magnetic Resonance Imaging: A Matched Cohort Analysis

To characterize hip capsule thickness on advanced imaging in patients with and without hip dysplasia and to also evaluate differences in capsular thickness between patients with borderline and patients with true dysplasia. Patients evaluated by the senior author for concerns of hip pathology from June 2020 to June 2021 were queried and images reviewed to determine dysplasia status by lateral center-edge angle (LCEA) ≤25°. A group of patients without dysplasia was identified and matched for age, sex, and body mass index. Hip capsular thickness was quantified using magnetic resonance imaging. A subanalysis was conducted to compare patients with true dysplasia (LCEA < 20°) with patients with borderline dysplasia (LCEAs between 20° and 25°). The analysis included independent samples t tests, χ2 tests, and multivariable regression. A total of eighty patients were included, with a mean age of 31.8 ± 11.7 years, a mean body mass index of 26.6 ± 6.5 points, and 70% (56) female patients. Patients with dysplasia had a mean LCEA of 19.8 ± 4.3°. Patients with dysplasia had decreased capsular thickness compared with patients without dysplasia (2.75 ± 0.96 mm vs 3.52 ± 1.22 mm, P= .003). Multivariable regression showed decreased capsular thickness associated with decreased LCEAs (β= 2.804, R= 0.432, P < .001) and dysplasia (β= -0.709, R2= 0.056, P= .004). Results of a subanalysis of the dysplastic group examining differences between accepted definitions of borderline dysplasia and true dysplasia showed no significant differences in capsular thickness between the 2 groups (P= .379). Patients with hip dysplasia were found to have thinner iliofemoral ligaments in the coronal plane on magnetic resonance imaging on magnetic resonance imaging. Further investigation is needed to evaluate any potential implications with hip instability, given the thinner hip capsule demonstrated in this study. Level III, retrospective comparative prognostic trial.

Capsular attachment on the anterosuperior femoral head-neck junction: A hypothesis about femoroacetabular impingement.

Femoroacetabular impingement (FAI), characterized by a pathological contact between the proximal femur and acetabulum, is a common precursor of hip osteoarthritis. Cam morphology is a bony prominence that causes FAI and frequently forms on the anterosuperior femoral head-neck junction. Despite anatomical consensus regarding the femoral head-neck junction as a boundary area covered by the articular cartilage and joint capsule, it remains unclear whether the joint capsule is continuous with the anterosuperior articular cartilage. For the anatomical consideration of cam morphology formation, this study aimed to investigate the histological characteristics of the capsular attachment on the anterosuperior femoral head-neck junction, particularly focusing on the presence or absence of continuity of the joint capsule to the articular cartilage. A total of 21 anterosuperior regions (seven hips each for the 12:00, 1:30, and 3:00 positions) from seven hips (three males and four females; mean age at death, 68.7 years) were histologically analyzed in this study for quantitative evaluation of the capsular thickness using histological sections stained with Masson's trichrome, as well as qualitative evaluation of the capsular attachment. The present study showed that the joint capsule, which folded proximally to the femoral head-neck junction from the recess, exhibited a blend of the fibrous and synovial regions. Notably, it not only continued with the superficial layer of the articular cartilage, but also attached to the articular cartilage via the fibrocartilage. This continuous region was relatively fibrous with dense connective tissue running in the longitudinal direction. The capsular thickness at the recess point (mean, 1.7 ± 0.9 mm) and those at the distal end of the articular cartilage (0.35 ± 0.16 mm) were significantly greater than the control value for the most superficial layer thickness of the articular cartilage (0.019 ± 0.003 mm) (Dunnett's T3, both p-value <0.001). Based on the fibrous continuity between the joint capsule and articular cartilage and its thickness, this study suggests the anatomical possibility that some mechanical stress can be transmitted from the joint capsule to the articular cartilage at the frequent sites of cam morphology.

Relationship Between Hip Capsular Thickness and Instability After Previous Hip Arthroscopic Surgery: A Matched-Cohort Analysis.

Thinner anterior hip capsules are associated with hip laxity, but there is little known about the impact of capsular thickness on the development of instability after primary hip arthroscopic surgery. To investigate the relationship between hip capsular thickness as measured on preoperative magnetic resonance imaging (MRI) and the development of hip instability after hip arthroscopic surgery for femoroacetabular impingement. Case-control study; Level of evidence, 3. We reviewed revision hip arthroscopic procedures performed between January 1, 2019, and May 1, 2021, at a single institution. Inclusion criteria were preoperative MRI/magnetic resonance arthrography, completion of the study traction protocol, and asymmetric distraction between the hips of ≥3 mm on examination under anesthesia. A comparison group of patients treated for femoroacetabular impingement with primary hip arthroscopic surgery who did not develop capsular instability were matched 1:1 to the patients with instability. Superolateral hip capsular thickness was measured on MRI before index surgery. Analysis was conducted using independent-samples t tests and multivariable linear regression. A total of 44 patients were included, with 22 patients each in the instability and no-instability groups. The mean capsular thickness was lower in the patients with hip instability than in those without (1.9 ± 0.6 vs 3.4 ± 1.1 mm, respectively; P < .001). Decreased capsular thickness was significantly associated with hips with instability versus no-instability (β = -1.468 [95% CI, -2.049 to -0.887]; P < .001). Thinner preoperative hip capsules in the region of the iliofemoral ligament were seen in patients who subsequently underwent revision arthroscopic surgery for hip instability compared to patients who underwent primary hip arthroscopic surgery without subsequent revision. Patients at a higher risk for the development of postoperative hip instability had a superolateral hip capsular thickness of <2 mm.

Biocompatibility of polyurethane-coated breast implants: A histological comparison of implant capsules.

Biocompatibility describes the influence of materials on their biological environment. Implant material in the human body can cause a foreign body reaction and the formation of a capsule around the foreign material. Since capsular formation is the most frequent issue after breast-implant insertion, knowledge and awareness of biocompatibility is crucial, especially since worldwide, breast augmentation continues to be the most popular plastic surgery, with over 1.6 million procedures performed in 2020, according to surveys by the International Society of Aesthetic Plastic Surgery (ISAPS). This study includes 80 capsular samples of female patients who underwent revision surgery after breast-implant insertion at the University Hospital Regensburg. Capsules of breast implants with different surface structures (smooth, textured and polyurethane-coated) and shapes (round-shaped, anatomically-shaped) were analyzed histologically after hematoxylin-eosin-staining in respect to capsular thickness and layer formation. Capsular thickness and layering showed a statistically significant difference between polyurethane-coated and smooth as well as polyurethane-coated and textured implants. Capsules around polyurethane-coated implants presented greater thickness. However, the difference between smooth and textured implants was not statistically significant. Furthermore, the shape of the implants also indicated a statistically significant difference in capsular thickness. Implants of anatomical shape resulted in a thinner capsule than round-shaped breast-implants. In conclusion, this study demonstrated a thicker capsule around polyurethane-coated breast implants and no difference in capsular thickness between smooth and textured breast implants. Anatomically shaped breast-implants presented a thinner capsule than round shaped breast-implants.

Association Between Anterior Hip Capsule Thickening and Sagittal Pelvic Alignment Among Patients With Developmental Dysplasia of the Hip.

The pathogenesis and pathology of secondary osteoarthritis (OA) of the hip, which is mainly due to developmental dysplasia of the hip (DDH), in Japan are obscure. There are some reports on the thickening of the hip capsule, but the relationship between the thickness of the hip capsule and the pelvic alignment due to hip deformity is not well known. This research investigated whether the capsular thickness of female DDH patients was related to pelvic alignment. This single-center cross-sectional study included female patients aged 50-79 years (n=13) who had undergone primary total hip arthroplasty (THA) due to secondary hip OA with a background of DDH. The part of the hip capsule including the iliofemoral ligament was resected and measured directly with a digital caliper. The Sharp angle, center-edge (CE) angle, sacral slope (SS), pelvic tilt (PT), pelvic incidence (PI), and lumbar lordosis angle (LLA) were measured with an X-ray image to investigate the relationship between the capsular thickness and the pelvic posture. Pearson's correlation coefficient showed a negative correlation between hip capsular thickness and Sharp angle (r=-0.57, p>0.05). No significant correlation was found between the thickness of the hip capsule and the sagittal X-ray parameters including SS, PT, PI, LLA, and CE angle in the coronal plane. The thickness of the hip capsule is moderately associated with the Sharp angle on the coronal plane. The results of this study suggest that the thickness of the joint capsule does not necessarily relate to the degenerative process among patients with DDH and the process can be complex to apply two-dimensional postural indices for the explanation.

Ultrasound had high accuracy in measuring hip joint capsule thickness

BackgroundThe hip joint capsule is an essential component of hip joint function and stability, and its thickness is closely associated with certain medical conditions, surgical outcomes, and rehabilitation treatments. Currently, in clinical practice, hip joint capsule thickness is predominantly measured using magnetic resonance imaging (MRI), with limited utilization of ultrasound examinations for this purpose.MethodsWe retrospectively evaluated patients who visited our Sports Medicine Department between February 2017 and March 2023 and underwent both hip joint MRI and ultrasound imaging on the same side. All patients had undergone preoperative hip joint MRI and ultrasound examinations, with the time gap between the two examinations not exceeding three months. Measurements of hip joint capsule thickness were taken on both MRI and ultrasound images for the same patients to analyze their consistency. Additionally, we measured the alpha angle, lateral center-edge angle, acetabular anteversion angle, and femoral anteversion angle of the patients’ hip joints and analyzed their correlation with hip joint capsule thickness measure by ultrasound.ResultsA total of 307 patients were included in this study, with hip joint capsule thickness measured by MRI and ultrasound being 5.0 ± 1.2 mm and 5.0 ± 1.5 mm, respectively. The Bland-Altman analysis demonstrates good agreement or consistency. The paired t-test resulted in a p-value of 0.708, indicating no significant statistical difference between the two methods. The correlation analysis between acetabular anteversion angle and ultrasound-measured capsule thickness yielded a p-value of 0.043, indicating acetabular anteversion angle and capsular thickness may have negative correlation.ConclusionsThe measurements of joint capsule thickness obtained through ultrasound and MRI showed good consistency, suggesting that ultrasound can be used in clinical practice as a replacement for MRI in measuring hip joint capsule thickness. There was a significant correlation between acetabular anteversion angle and hip joint capsule thickness, indicating potential for further research in this area.

Evaluating Hip Periprosthetic Joint Infection with Metal-artifact-reduction MR Imaging.

To evaluate the significant findings of hip periprosthetic joint infection (PJI) using metal-artifact-reduction (MAR) MRI and to compare the MRI results to other clinical markers. The results of MRI, including two-dimensional fast-spin echo sequences with increased bandwidth and multi-acquisition variable-resonance image combination selective for hips with orthopedic implants at 1.5T (from April 2014 to November 2021), were retrospectively assessed for imaging findings and diagnostic impressions by two radiologists. Clinical data and courses were also investigated. Univariate and multivariate analyses were performed to identify the significant MRI findings in patients with hip PJI and those who underwent surgical intervention. The MRI impressions were compared with other clinical markers in diagnosing hip PJI. Thirty-seven hip joints in 24 Asian patients (age = 73.9 ± 10.8 years; 18 females) were included. Twelve hip joints (32%) had PJI; seven underwent a surgical intervention. The significant findings for hip PJI included periosteal edema of the acetabulum, intermuscular edema, intramuscular fluid collection, and lymphadenopathy (P < 0.05). In the cases with surgical intervention, the significant findings included capsular distension, capsular thickening, an osteolysis-like pattern of the femur, subcutaneous fluid collection, and lymphadenopathy (P < 0.05). The MRI impressions had high diagnostic significance for both hip PJI cases and those with surgical intervention (P < 0.001). The MRI impression was more significant for hip PJI than the other clinical markers (P < 0.05), while the other clinical markers were more significant in the cases with surgical intervention (P < 0.05). The significant findings in the hip PJI cases included acetabular periosteal edema, intermuscular edema, intramuscular fluid collection, and lymphadenopathy. The significant findings in the cases with surgical intervention included capsular distention, capsular thickening, a femoral osteolysis-like pattern, subcutaneous fluid collection, and lymphadenopathy. The utilization of MAR MRI demonstrated great diagnostic significance for hip PJI.

Prevalence and Correlation between MRI Findings and Outcome of Conservative Treatment in Primary Idiopathic Frozen Shoulder.

Primary idiopathic frozen shoulder (FS) causes pain and stiffness in the shoulder joint. Over time, this disease causes restriction of shoulder motion. We undertook this study to evaluate possible correlation of MRI findings with outcome of conservative management in FS. A total of 65 cases participated in prospective cohort study. The correlation of MRI findings obtained before commencing the treatment with outcome of non-operative management (Mean of ROM, VAS, SST and OSS) was evaluated. Anterior extracapsular edema significantly correlated with FF, EXR, VAS (a) and OSS. The effusion in humeral side of axillary recess significantly correlated with ROM restriction in ABD, EXR. Capsular thickness of glenoid portion showed good significance with FF, ABD, VAS (a) and OSS. Increased thickness of CHL showed negative correlation with improvement of EXR (P=0.049) (r=-0.617). Thickening of IGHL showed negative correlation with improvement of ABD (p=0.005 r=-0.862) and FF (p=0.007 r=-0.831). Mean Height of Axillary recess (HAR) was 7.2mm (3.5-11mm). HAR showed negative correlation with VAS pain scale (P=0.036) (r=-0.682) and OSS (P=0.038) (r=-0.668). Thickness of the joint capsule and effusion at the axillary fold are important factors for refractory frozen shoulder. We can recommend MRI for refractive cases and low threshold of expectation can be set for conservative management in patients with above findings.

Carbon source-dependent capsule thickness regulation in Streptococcus pneumoniae.

The polysaccharide capsule of Streptococcus pneumoniae plays a major role in virulence, adherence to epithelial cells, and overall survival of the bacterium in the human host. Galactose, mannose, and N-acetylglucosamine (GlcNAc) are likely to be relevant for metabolization in the nasopharynx, while glucose is the primary carbon source in the blood. In this study, we aim to further the understanding of the influence of carbon sources on pneumococcal growth, capsule biosynthesis, and subsequent adherence potential. We tested the growth behavior of clinical wild-type and capsule knockout S. pneumoniae strains, using galactose, GlcNAc, mannose, and glucose as carbon source for growth. We measured capsule thickness and quantified capsule precursors by fluorescein isothiocyanate (FITC)-dextran exclusion assays and 31P-nuclear magnetic resonance measurements, respectively. We also performed epithelial adherence assays using Detroit 562 cells and performed a transcriptome analysis (RNA sequencing). We observed a reduced growth in galactose, mannose, and GlcNAc compared to growth in glucose and found capsular size reductions in mannose and GlcNAc compared to galactose and glucose. Additionally, capsular precursor measurements of uridine diphosphate-(UDP)-glucose and UDP-galactose showed less accumulation of precursors in GlcNAc or mannose than in glucose and galactose, indicating a possible link with the received capsular thickness measurements. Epithelial adherence assays showed an increase in adherence potential for a pneumococcal strain, when grown in mannose compared to glucose. Finally, transcriptome analysis of four clinical isolates revealed not only strain specific but also common carbon source-specific gene expression. Our findings may indicate a careful adaption of the lifestyle of S. pneumoniae according to the monosaccharides encountered in the respective human niche.

Okra [Abelmoschus esculentus (L.) Moench] improved blood glucose and restored histopathological alterations in splenic tissues in a rat model with streptozotocin-induced type 1 diabetes through CD8+ T cells and NF-kβ expression.

Diabetes mellitus is a complex metabolic syndrome that involves dysfunction of spleen and other lymphoid organs. Medicinal plants, including okra (Abelmoschus esculentus (L.) Moench), were used widely for diabetes treatment. Scarce data are available about the potential anti-diabetic effects of okra, the histopathological alterations in splenic tissues and the mechanistic pathways underlying this association. The current research investigated the effects of okra pod extract on the biochemical parameters and expression of CD8+ T cells and nuclear factor kappa (NF-k) B and releasing proinflammatory cytokines in spleen in streptozotocin (STZ)-induced diabetic rat models. A total of 50 mature male Wister albino rats were divided into five isolated groups; the first served as control (untreated) animals, the second (DM group) diabetes induced by STZ (at a dose of 45 mg/kg body weight, administered intraperitoneally), the third group (DM + Insulin): diabetic rats administered insulin subcutaneously (10 units/kg bw/day) daily for 4 weeks, the fourth group was administrated 400 mg/kg okra extract daily for 4 weeks, and diabetic induced rats in the fifth group were administrated 400 mg/kg okra extract daily for 4 weeks. The 2,2-diphenyl-1-picrylhydrazyl (DPPH) scavenging activity in Abelmoschus esculentus (L.) Moench was studied, and the content of phenolic compounds in okra pods was estimated using high-performance liquid chromatography. Diabetes induction led to decreased body weight, increased blood glucose levels. Capsular thickness was significantly increased, white pulp was widely dispersed, and mature lymphocytes in the periphery were also drastically decreased, with thick follicular arteries, necrosis, and depletion of lymphocytes in the germinal center. Red pulp revealed severe congestion and degenerative changes, deposition of hemosiderin granules and lymphocytic depletion. In addition, collagen fiber deposition was increased also in this group. The induction of diabetes exaggerated NF-kβ expression and mediated downregulation of the expression of CD8+ T cells in spleen tissue. Interestingly, oral administration of okra extracts post diabetes induction could mitigate and reverse such adverse effects. Altogether, our study points out the potential benefits of okra in improving blood glucose levels and restoring histopathological alterations in splenic tissues through CD8+ T cells and NF-kβ expression in a diabetic rat model.

Capsular and retinaculum thickening in type II mucopolysaccharidosis: a novel MRI finding.

Mucopolysaccharidoses (MPS) are a group of inherited lysosomal storage diseases caused by a deficiency of glycosaminoglycan (GAG) catalytic enzymes, resulting in an accumulation of unprocessed or partly degraded GAGs in different tissues, including bones and joints. Notably, skeletal and joint abnormalities may be the first complaint that prompts patients to seek medical attention, especially in the milder forms of the disease. To our knowledge, there are no prior imaging reports that have documented capsuloligamentous thickening in patients with MPS on MRI. In this study, we present four cases of patients with clinically and genetically confirmed diagnosis of type II MPS, encompassing seven MRI examination of different joints, including cervical spine, hip, wrist, knee, and shoulder. All of the patients were male, aged between 14 and 35years, and exhibited varying degrees of joint stiffness in the clinical examination and carpal tunnel syndrome in cases of the wrist joint was affected. None of the patients had a history of surgical procedures on the affected joint, other metabolic or deposit diseases, or sports activity practice. The MRI revealed significant capsuloligamentous and retinaculum thickening, up to eight times greater than the normal capsular thickness reported in the literature.

Influence of p16 Protein Immunostaining on Histopathological Features of Pleomorphic Adenoma and Carcinoma ex- Pleomorphic Adenoma.

The objective of this study was to evaluate the role of p16 in histologic characteristics and transition of Pleomorphic Adenoma (PA) to Carcinoma ex-PA (CxPA). So, 60 PA and 4 CxPA were histologic reviewed based on microscopic characteristics proposed by Hellquist, Triantafyllou and Dulguerov (PA) and Morais, Antony and Toluie (CxPA). Immunostaining for p16 was associated in different parenchyma and stroma of both tumors and Fisher's/chi-square tests and Mann-Whitney test were performed (SPSS v20.0, p<0.05). In PA the periductal cells were predominantly p16- and that ductal and myoepithelial cells showed a significant increase in p16+ cells (p<0.001). In CxPA, none of the cases showed p16+ in periductal cells, most parotid cases showed p16+ in ductal cells, and one case of parotid and the submandibular case showed mild immunostaining for myoepithelial cells. There was a small reduction in p16+ in CxPA compared to PA (p=0.537), but in both tumors there was less p16+ cells in solid stroma than other (p<0.001). The p16+ cases of PA had a higher capsular thickness (p=0.047). So, the loss of p16 immunostaining does not seem to be associated with the transition from PA to CxPA, but in both tumors the loss of p16+ cells are related to microscopic aggressiveness.

Evaluation of Adhesive Capsulitis of the Shoulder with Fat-Suppressed T2 Weighted MRI: Association between Clinical Features and MRI Findings

Introduction •Adhesive capsulitis of the shoulder or frozen shoulder is a debilitating condition characterized by progressive pain, stiffness and limited range of motion about the glenohumeral joint, the term (adhesive capsulitis) to describe the findings of chronic inflammation and fibrosis of the joint capsule, characterized by significant restriction of both active and passive shoulder motion that occurs in the absence of a known intrinsic shoulder disorder. (Zhao W, ZhengX, liu Y, et al.,2012). •MRI has, in recent years, allowed for the visualization of several characteristic signs seen with this condition, including thickening and shortening of the coracohumeral (CHL) ligament, thus limiting external rotation is due to fibroblastic proliferation within the CHL, thickening of axillary pouch and rotator interval joint capsule, in addition to the obliteration of the subcoracoid fat triangle.(Cheng X, et al.,2017). Aim of the work to examine the association between clinical features (stages) and MRI findings in adhesive capsulitis of the shoulder. Methods and material seventy patients confirmed or suspected adhesive capsulitis of the shoulder. The diagnosis is based on MRI findings and clinical criteria. Patients who complain from shoulder pain and restricted ROM with detailed clinical information and history which permit the clinical staging of AC and patients with normal ROM in the opposite shoulder are also included (the initial diagnosis was based on the history and clinical symptoms) clinical criteria for the diagnosis of AC includes: restricted passive motion for greater than 30 degrees in the two or more planes of movement, gradually increasing shoulder pain that was more severe at rest at least 1 month duration, and normal radiographic findings .Patients who fullified these criteria underwent shoulder MRI to correlate MRI findings with pain intensity, range of motion and clinical stage. Study is approved by the ethics review board of Ain Shams University Hospital. For the MRI examination, (a 1.5 tesla Philips Healthcare) MRI machine at El-Demerdash University Hospitals with a dedicated shoulder surface phased –array coil. During imaging, patients were in supine position .MRI protocol consisted of the following sequences:Fat-suppressed T2: coronal oblique, sagittal and axial weighted images, proton density(PD), fast spin echo T1-Weighted sagittal images.All patients will be subjected to complete history taking, full clinical examination. All MRI imaging examinations were conducted at radiology department of Ain Shams University. All patients were subjected to full history taking prior to scanning and full clinical examination. Results Regarding the diagnostic performance of shoulder MRI there is a statistically significant difference between degree of pain intensity according to Capsular thickening regarding humeral “mm” with p-value (p &amp;lt; 0.05). The highest value was found moderate and severe pain group (5.67±1.39) compared to absent, minimal &amp; mild pain group (4.42±1.29)., there was a statistically significant difference between two groups according to axillary recess regarding height “mm” with p-value (p &amp;lt; 0.05). The highest value was found absent, minimal &amp; mild pain group (7.02±2.68) compared to moderate and severe pain group (5.73±2.25). There is no statistically significant association between pain intensity and MRI finding regarding Capsular Edema, Extra Capsular Edema, Obliteration of Subcoracoid Fat Triangle, Effusion of Biceps Tendon Sheath, Capsular Thickening Glenoid (mm) and Axillary Recess Width (mm), with p-value (p &amp;gt; 0.05 NS). •Qualitative and quantitative analysis a highly statistically significant difference between absent and present of limitation of ROM “abduction” according to Capsular Thickening Glenoid (mm) with p-value (p &amp;lt; 0.001). The highest value was found absent group (6.29±0.99) compared to present group (5.21±1.39). •Additionally, the results showed 25 patients out of 70 having extra capsular edema anterior, 20 patients (48.8%) belong to absent abduction group and 5 patients (17.2%) belong to present abduction group, as there was a statistically significant negative relation with p-value (p = 0.014). •There is no statistically significant association between absent and present of limitation of ROM “abduction” and MRI finding regarding Capsular Edema Glenoid, Capsular Edema Humeral, Extra Capsular Edema Posterior, Obliteration of Subcoracoid Fat Triangle, Effusion of Biceps Tendon Sheath, Capsular Thickening Humeral (mm), Axillary Recess Height (mm) and Axillary Recess Width (mm), with p-value (p &amp;gt; 0.05 NS) Conclusion MRI can be useful for assessment several measures of clinical impairment in patients with adhesive capsulitis . thickening and hyperintensity of the joint capsule in the axillary recess on MRI is associated with limited ROM and duration of symptoms.

The Possible Effect of Grape Seed Extract on the Adrenal Cortex in Streptozotocin-Induced Diabetes in Male Albino Rats: A Histological Study

Abstract Introduction Induction of diabetes in rat models injected with streptozotocin (STZ) had led to increase activity of the hypothalamic-pituitary-adrenal (HPA) axis accompanied with hypercortisolism and adrenocortical growth. Proanthocyanidin, a grape seed extract (GSE) that was observed to have beneficial effect on different metabolic and inflammatory diseases. Aim To study the structural changes of the adrenal cortex in diabetic rats and the beneficial effect of GSE on the suprarenal cortical injury. Materials and methods 35 adult male albino rats were divided randomly into 4 groups. Group I (control). Group II (GSE), rats received GSE orally (200 mg/kg), daily for 21 days. Group III (STZ), rats were injected with STZ (40 mg/kg) given intraperitoneal once. Group IV (STZ + GSE), rats received STZ as in group III. After rats confirmed to be diabetic, they were treated with GSE as in group II. After 21 days, the adrenal glands from all groups were dissected and processed for light microscopic examination. Morphometric and statistical analysis were also done. Results H&amp;E stained section of Group III (STZ) showed increase in the capsular thickness and congested blood capillaries. Both zona glomerulosa &amp; zona fasciculata showed increased thickness with some cells appeared with vacuolated acidophilic cytoplasm while others were shrunken with closely packed pyknotic nuclei. Inflammatory cells infiltration was also observed. Moreover, silver stain showed focal significant increase in thickness of the capsule, dense trabeculae and dense irregular reticular fibers of the cortex. Meanwhile, immunohistochemical results showed significant increase in the reaction for caspase 3 antibodies. Group IV (STZ + GSE) showed restoration of the cortical structure &amp; organization nearly similar to that of control group. Conclusion It can be considered that GSE might have a protective effect on the structure of diabetic rats’ adrenal gland.

The effects of curcumin on the fibrous envelope surrounding silicone implants in rats

Background Capsular contracture is the most common serious breast surgery complication. The cause of capsular formation remains unknown, but chronic inflammation is commonly considered to cause excessive fibrosis. Curcumin has anti-inflammatory effects and thus can relieve the symptoms of inflammatory diseases, as demonstrated in animal studies. This study aimed to evaluate the effects of curcumin on the fibrous envelope covering silicone implants in a rat model.Methods Two solid 1.8-cm oval-shaped silicone implants were placed beneath both sides of the back in 20 Sprague-Dawley rats. The control group included 10 rats that were fed a normal diet (group A), while the experimental group (group B) included the remaining 10 rats that were fed ground curcumin. En bloc excision was conducted at 8 postoperative weeks. Capsular thickness and inflammatory cell distribution were examined using a fixed tissue sample.Results Gross findings and histologic differences between the groups were observed. The experimental group had a significantly lower mean total capsular thickness than the control group (177.4±31.4 μm vs. 145.9±32.5 μm, P=0.007). A significant decreasing tendency was found in several inflammatory cells in the experimental group (7,070±744.3/mm&lt;sup&gt;2&lt;/sup&gt; vs. 2,640±301.7/mm&lt;sup&gt;2&lt;/sup&gt;, P=0.001).Conclusions Curcumin significantly reduced the inflammatory reaction, and will help to lower the risk of capsular contracture. Long-term studies are required to determine whether this hypothesis can provide a basis for a viable therapeutic strategy to reduce capsular contracture.

Histopathological effectiveness of vitex agnus castus in treating polycystic ovaries induced by letrozole in female rabbits

Female fertility is significantly impact by the common endocrine health issue known as polycystic ovarian syndrome (PCOS) in the childbearing years, Due to their ease of use and reduced cost-effectiveness when compared to chemical medicines generated via synthesis, therapeutic wild plants and herbs have been prized agents in the management of different illnesses for ages. Premenstrual syndrome, mastalgia, infertility, and menstrual cycle control are among the numerous conditions and diseases that can be treated with Vitex agnus-castus, a well-known medicinal plant that is native to the Mediterranean region and is widely used in Europe, Asia, and North Africa. The purpose of the study is to learn more about Vitex agnus catus and evaluate its efficacy in treating polycystic ovaries induced by letrozole in comparison to clomiphene citrate therapy. Since the effects of herbal activity are assessed by, observing histopathological changes in rabbit ovaries. The incidence of subcapsular ovarian cysts, capsular thickness, incomplete luteinization, and the quantity of corpora lutea were all higher in the research groups' ovaries. Compared to the group with a positive control (treated with normal saline only and administered orally). Histopathological study of the rabbit ovaries for both treatment groups revealed hyperplasia of the surface epithelium and congested blood vessels of the ovaries.

The modified capsular arthroplasty foryoung patients with developmental dislocation ofthe hip.

The present study aimed to investigate the clinical results of the modified Codivilla-Hey Groves-Colonna capsular arthroplasty in the treatment of young patients with developmental dislocation of the hip. We retrospectively evaluated 90 patients (92 hips) who underwent the modified capsular arthroplasty from June 2012 to June 2021. Hips were evaluated using the modified hip Harris score (mHHS), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score and the 12-item International Hip Outcome Tool (iHOT-12). The Tönnis osteoarthritis grade and the Severin classification system were used to assess the radiographic outcomes. The average age was 15.7 years (range: 8-26 years). The mean pre-operative mHHS, the WOMAC score and the iHOT-12 score were 83.03, 14.05 and 52.79, respectively. The patients were followed for a mean of 41.1 months (range: 12.1-120.9 months). The patients had a mean mHHS of 83.61 (range: 31.2-97), a WOMAC score of 16.41 (range: 0-51) and an iHOT-12 score of 64.81 (range: 12.9-98.2) at the final follow-up. Capsular thickness had a positive predication on the final functional outcomes. The excellent/good rate of radiological reduction was 79.3%. More than 60% of patients had no/slight osteoarthritis. A total of 54 hips (58.7%) had superior radiographic outcomes. The risk factors for inferior radiographic outcomes were capsular quality (odds ratio [OR]: 0.358, 95% confidence interval [CI]: 0.113-0.931) and capsular thickness (OR: 0.265, 95% CI: 0.134-0.525). Joint stiffness was the most common complication (14.1%). We confirmed the efficacy of this procedure in the treatment of developmental hip dislocation. Patients with poor capsular quality are not suitable for this procedure. With suitable selection according to indications, this procedure can restore the hip rotation center with a low incidence of femoral head necrosis or severe osteoarthritis.