Degenerative Changes Research Articles (Page 1)

Identifying pain generators for cervical spine patients can be challenging, particularly in those with prior surgery. Single-photon emission computed tomography (SPECT/CT) may help localize potential areas of pain generation through increased radionuclide uptake.We conducted a single-institution retrospective cohort study evaluating the concordance between MRI and SPECT/CT findings and assessing outcomes after surgery targeting spinal levels with increased uptake. Demographic, clinical, and imaging data were extracted. Degenerative changes (spondylosis, facet arthropathy, stenosis, disc disease) seen on MRI were compared with SPECT/CT to determine concordance. Primary outcomes included change in neck disability index (NDI) and visual analog scale (VAS) pain scores. A 30% reduction in NDI from baseline defined the minimal clinically important difference (MCID).Fifty-three patients with both SPECT/CT and MRI were identified. Increased radionuclide uptake was seen in 50 (94%) patients; 40 (75.5%) had concordant degenerative findings on MRI. Twenty-nine (54.7%) had prior cervical instrumentation, of whom 16 (55%) had uptake at the instrumented level, and 12 (41%) had uptake at adjacent levels. Twenty patients underwent surgery targeting SPECT-positive levels. All patients demonstrated significant improvements in NDI (mean 36.2%, p < 0.001) and VAS (p < 0.001).SPECT/CT may serve as a valuable adjunct to MRI in evaluating cervical spine pathology, particularly in complex or postoperative cases. Patients who underwent surgery directed by SPECT/CT findings experienced meaningful clinical improvements. Further prospective studies are needed to validate its utility and cost-effectiveness.

Tramadol (TRM) is a centrally acting analgesic drug used for management of moderate to severe pain. Granulocyte colony-stimulating factor (G-CSF) is a cytokine that has the ability to mobilize stem cells from the bone marrow to the peripheral circulation. This study was performed to evaluate the histological and biochemical alterations in the adrenal cortex after intake of tramadol and the possible protective role of G-CSF on it. Fifty adult male albino rats were divided into three groups: Group I as a control group, group II (TRM treated group) received a daily dose of 80 mg/kg body weight orally via gastric tube for 12 weeks and group III (TRM+G-CSF-treated group) received subcutaneous injections of 100 μg/kg body weight of G-CSF for seven consecutive days, then TRM from the 8th day to the end of the experiment in the same dose as group II. At the end of the experiment, blood samples were taken for hormonal essay and tissue samples were processed. Light and electron microscopic studies were done. Morphometric and statistical studies were carried out. The study revealed that TRM induced histological and ultrastructural degenerative changes, decreased serum levels of aldosterone, cortisol, and dehydroepiandrosterone, as well as a strong positive Bax immune reaction. However, G-CSF reversed these alterations and showed a strong positive CD34 immune reaction. In conclusion: G-CSF improved histological, biochemical and immunohistochemical metrics in the rat adrenal cortex after tramadol-induced injury.

Relevance. Mandibular underdevelopment in adolescents without syndromic pathology is often associated with temporomandibular joint (TMJ) disorders and presents with marked facial asymmetry, malocclusion, and functional impairment. Conventional orthognathic surgery in patients with incomplete facial skeletal growth carries a high risk of relapse and considerable surgical morbidity. Mandibular distraction osteogenesis (DO) is regarded as a less invasive alternative to orthognathic surgery. Clinical case descriptions. Three adolescents (two females, 17 years; one male, 16 years) with nonsyndromic mandibular hypoplasia secondary to TMJ degenerative changes were included in case series. All patients underwent mandibular distraction osteogenesis using intraoral curvilinear distractors (Conmet, Moscow, Russia). Preoperative planning was performed using multislice computed tomography (MSCT) and lateral cephalometric radiography. Mandibular elongation aranged from 12 to 16 mm. Treatment resulted in substantial correction of facial asymmetry, normalization of occlusion, and satisfactory regenerate quality, as confirmed on CT and ultrasonography. No complications were observed. Conclusion. In adolescents, intraoral curvilinear distractors provide an effective, minimally invasive approach to correcting nonsyndromic mandibular hypoplasia, reducing the need for orthognathic surgery and minimizing complications.

The research was done to explore the influence of quinoa extract on periodontium, and to assess serum YKL-40 level in a depression rat model. An overall number of 30 male albino rats weighing170-180 g were used. Animals were grouped into three categories; group I: control group, group II: depressed group, group III: depressed group treated with 600 mg/kg body weight quinoa extract. The experimental duration extended to a period of 21 days. Blood samples obtained from the heart were transported to biochemistry tubes for ELISA analysis following euthanization. Mandibular molar region specimens were subjected to decalcification for histological evaluation. Quinoa extract ameliorated the degenerative changes of periodontium in the experimental depression model, increased body weight and serum serotonin level, and decreased serum cortisol and YKL-40 levels. Quinoa extract may be utilized as a preventative measure against the periodontal damage brought on by depression.

Early-Onset Degenerative Bone Changes as a Manifestation of Alkaptonuria: A Case Report

Background: Uterine leiomyomas, commonly known as fibroids, are prevalent benign tumors in women of reproductive age. While often asymptomatic, they can become symptomatic when they enlarge or when degenerative changes occur. Cystic degeneration, which occurs in approximately 4% of leiomyomas, presents a diagnostic challenge, as it can mimic malignancy on imaging due to its solid-cystic appearance on imaging. This case report aims to highlight the diagnostic dilemma posed by large leiomyomas with cystic degeneration and to emphasize the importance of advanced imaging as well as histopathological examination in confirming benign diagnoses and excluding malignancy. Case Presentation: A 27-year-old woman presented with progressive abdominal distension and intermittent lower abdominal pain over thepast year. Imaging revealed a large, solid-cystic mass in the uterine fundus, raising suspicion of malignancy. Further diagnostic workup, including magnetic resonance imaging (MRI) and histopathological examination, confirmed the massas a benign leiomyoma with cystic degeneration. The patient underwent a laparotomy myomectomy, and intraoperative findings confirmed a well-circumscribed subserosal mass with cystic degeneration. Histopathology examination alsoconfirmed a benign leiomyoma, ruling out malignancy. Conclusion: This case underscores the diagnostic challenges of differentiating large leiomyomas with cystic degeneration from malignancies. Advanced imaging, particularly MRI, along with histopathological examination, plays a crucial role in establishing an accurate diagnosis and subsequently, guiding appropriate management.

Background: Infectious bronchitis virus (IBV) is a highly spreading, evolving virus that induces multiple manifestations, including respiratory, urinary, and reproductive symptoms, and presents a considerable risk to the Egyptian poultry sector. This study assessed various IBV vaccination protocols available in broiler populations comprising live attenuated vaccines such as IB Var II, 793/B (4/91), IB Primer, and H120 against the local novel IBV-GI-23.3 strain. Methods: Vaccines were administered to eight groups of SPF chicks at 1 day only or 1 + 14 days of age. Birds were challenged via the oculo-nasal route at 28 days of age using 106 EID50/0.2 mL/chick with the NewValley-1-EGYIBV-GI23.3-2023 local strain. Ciliostasis activity and the scores for histopathological lesions were evaluated at 7 days post-challenge (DPC). Virus shedding was monitored at 3, 5, and 7 DPC using the real-time RT-PCR method. Results: The ciliostasis test indicated that the vaccinated groups receiving the IB Primer + 4/91 vaccine regime at 1 day only or 1 + 14 days of age received the highest level of protection (65%, 68%, respectively). Similarly, administration of IB Primer + IB Var II at 1 + 14 days of age demonstrated substantial protection (63%). Conversely, administering the H120 + 4/91 vaccination protocol at days 1 and 14 resulted in a moderate level of protection (53%). Tracheal IBV shedding quantification and subsequent histopathological signs of trachea, proventriculus, bursa, and kidney degenerative changes were significantly lower in the vaccinated groups (especially the IB Primer + 4/91 vaccine regime at 1 day only or 1 + 14 days) than in the positive control groups. Conclusions: The heterologous combined IB Primer + 4/91 program demonstrated the most significant protective efficacy against the IBV field challenge strains compared with other vaccines in broiler chickens.

Introduction. Chronic inflammation in rheumatoid arthritis (RA) is one of the causes of activation of bone resorption, occurrence of erosive changes, disruption of microarchitecture, bone mineral density (BMD) decrease and increased risk of vertebral and peripheral bone fractures. The aim – to study the dynamics of bone mineral density, vertebral deformations and degenerative changes in the lumbar spine in patients with rheumatoid arthritis during long-term prospective observation. Materials and methods. A prospective multi-year cohort study, the duration of which was 9.7±1.7 years, included 151 women with RA aged 53.9±9.2 years with a reliable diagnosis established at the age of 41.9±12.5 years. All patients underwent clinical, laboratory and radiological examination (X-ray densitometry of the lumbar spine (L1–L4), femoral neck (FN) and total hip (TH), X-ray morphometry of the spine using the Genant method, assessment of degenerative changes in the lumbar spine) in dynamics. Results. A BMD decrease in FN and TH and stabilization in L1–L4 were established; in patients over 55 years of age it was an increase in BMD in L1–L4 and a decrease in FN and TH; a decrease in BMD in all studied skeletal regions in patients under 55 years of age. The appearance or increase in deformations (fractures) of the vertebrae in the thoracic spine was observed in 50 (33%) patients, in the lumbar spine – in 4 (2.6%) patients; a relationship between deformations (fractures) of the vertebrae and an increase in BMD was not established. An increase in degenerative changes in all segments of the lumbar spine was established in patients with pain and a significant increase in L1–L4 BMD. Long-term monotherapy with DMARDs, as well as with biologics, did not have a positive effect on the BMD. Conclusions. A long-term prospective cohort study revealed stabilization of the BMD in L1–L4; its increase in the group of patients with RA over 55 years of age against the background of the appearance or intensification of the initial deformation (fractures) of the vertebrae; and an increase in degenerative changes in all segments of the lumbar spine.

The aim of our research was to determine the progression of postmortem ocular changes, focusing on the retina and sclera, over a specified time period and to assess whether these changes are influenced by environmental or physiological factors.Twelve Wistar rats were divided into four experimental groups based on postmortem interval (PMI): immediate autopsy (control), 24h, 48h, and 72h. The mechanism of death was asphyxia by hanging. Each eye sample was macroscopically and microscopically monitored for retinal and scleral changes depending on the PMI and eye exposure (open vs. closed).The most pronounced ocular changes were observed at the longest PMI, including complete loss of retinal stratification, degeneration of ganglion cells, and infiltration by mononuclear inflammatory cells. Similar degenerative changes were observed in the scleral epithelium, particularly in open eyes.This experimental model provides a foundational framework for studying postmortem ocular changes, particularly in the retina and sclera, and may enhance the accuracy of PMI estimation in forensic investigations.

Effects of apigenin on mesangial GATA3 expression and PDGFR-β/NF-κB signaling pathway in experimental diabetic nephropathy model.

Abstract Introduction Inflammatory myopathic conditions are rare autoimmune diseases that usually present with clinical features of muscle weakness, with or without dermatological findings. Initial investigations include biochemical and immunological tests, and detailed imaging via magnetic resonance imaging (MRI). Further targeted investigations may involve electromyography (EMG) and biopsies. These findings, taken together, would support diagnosis of myositis. However, positive findings in isolation can be misleading and may inform incorrect management. Here, we present a patient with reported myositis on imaging. Through this, we are reminded to look at the entire clinical picture whilst also accounting for negative findings and considering other likely differentials. Case description This is a case of a 76-year-old gentleman with a background of vascular dementia, moderate frailty, atrial valve replacement, and epilepsy. He is fully independent. He was previously admitted thrice over three consecutive months for swollen left calf, treated as cellulitis and fluid overload. On the third admission, MRI of his left leg revealed widespread patchy oedema and fatty atrophy in the medial belly of gastrocnemius, which was enlarged, and concerning for focal myositis. One month later, he presented again for left leg swelling and erythema, and haematology opinion was sought. He denied any pain, weakness, rash, photosensitivity, dysphagia nor mobility issues. He had no sicca nor systemic symptoms. There was normal proximal power in all four limbs. There was pitting oedema in the legs bilaterally with left leg being swollen, red and warm. Initial differential diagnoses included changes due to recurrent cellulitis, or focal myositis secondary to radiculopathy. Complement, CK, immunoglobulins, RF, ANCA, TFTs and haematinics were normal. Blood borne virus screen was negative. CRP and ESR were slightly elevated at 38 mg/L (0-5 mg/L) and 37mm/h (0-20mm/h) respectively, with negative procalcitonin. Myositis antibodies and ENA were negative. His ANA was positive, but of uncertain significance. MRI left leg was repeated a year later, showing similar appearances. MRI spine showed degenerative changes. Nerve conduction studies (NCS) and electromyography (EMG) findings were in keeping with localised muscle injury. No evidence was found of active inflammatory myopathy or polymyositis. There was neurogenic abnormality in a sampled left leg muscle which was most likely radiculopathy. In the absence of clinical features of myositis and non-specific MRI findings, he was referred to the neuromuscular team who felt that the findings were incidental. He was safety netted and discharged from the rheumatology service. Discussion This gentleman presented multiple times with the same localised, unilateral oedema and myositic changes focally in his left calf over several years. The focal, nature of the condition argued against it being a systemic myositis. Although ANA results were positive, ENA and extended myositis screen were negative, and there were no systemic symptoms or rash, arguing against a systemic myositis. In addition, the stability of the appearances over the course of a year suggests a non-autoimmune cause, as progression might otherwise be expected in this time. Radiculopathy-related myositis is reported on a case-study basis, but due to the rarity of the condition, incidence rate is unknown. No specific focal treatment is required, other than consideration of management of the initial radiculopathy if appropriate, and careful exclusion of other causes, including malignancy, to ensure patient safety. Key learning points Unilateral myositis is unusual. The whole clinical picture should be assessed, and should always prompt a careful consideration of atypical causes not related to autoimmune conditions, especially in the absence of convincing supporting autoimmune screen, triggers, or systemic symptoms. Supporting investigations such as full autoimmune screen, MRI, NCS/EMG and muscle biopsy should be considered, as well as a careful drug and family history. MDT involvement is useful in the assessment of myositis of unclear cause, with additional investigations such as muscle biopsy considered where there is diagnostic uncertainty. Formal neuromuscular opinion should be sought in all cases of uncertainty to ensure rare neurological causes are considered if appropriate. Systemic treatments for focal myositis should be avoided where there is diagnostic uncertainty, except in cases of severe, rapidly progressive or life-threatening symptoms. This allows the correct diagnosis to be reached and an appropriate long-term plan formulated.

Background.Removable plastic dentures (RPDs) remain essential for edentulous patients, yet their interaction with oral tissues can precipitate inflammatory and degenerative changes that compromise both comfort and treatment longevity.Objective.To quantify and characterise morphological alterations of the oral mucosa in long‑term RPD wearers and to determine the influence of prosthesis quality, hygiene practices and duration of use on the severity of these changes.Methods.A cross‑sectional clinical study was performed on 65 patients aged ≥50years who had worn complete or partial RPDs for at least 12months. Standardised intra‑oral examinations assessed colour, texture, exudation and lesion type; tongue coating and salivary moisture were also recorded. Prosthesis fit and surface roughness were determined by visual and tactile inspection. Oral hygiene habits were documented with a validated questionnaire. Eleven patients consented to punch biopsy for histopathological confirmation. Participants were stratified into groups with and without mucosal lesions. Associations were analysed using χ² and Student’st‑tests (α=0.05).Results.Forty‑five patients (69%) showed clinically obvious mucosal damage: catarrhal inflammation (34/65, 52%), hyperplastic growths (11/65, 17%) and acrylic intolerance (2/65, 3%). Lesions correlated strongly with inadequate hygiene (p&lt;0.01) and low‑quality dentures (p=0.02). Wear time exceeding five years doubled the risk of pathology (OR=2.1; 95%CI1.1–3.9). Histology corroborated chronic inflammatory infiltration and epithelial degenerative changes. Conclusion.Poorly fabricated or poorly maintained RPDs markedly increase theprevalence of pathological mucosal reactions. Regular professional follow‑up, patient‑centred hygiene education and timely remanufacture are pivotal for preserving oral tissue health.Keywords:oral mucosa,dentures,inflammation,biofilms,mouth diseases.

Background: An in-situ saphenous vein bypass graft pseudoaneurysm represents a highly infrequent late complication. A 56-year-old male who had undergone femoropopliteal bypass surgery using an in-situ great saphenous vein nine years prior developed an unnoticeable false aneurysm located in the middle portion of the graft. We examine vein graft aneurysms, including their frequency of occurrence, pathogenesis, diagnostic methods, and treatment options. Case Summary: The patient exhibited an unnoticeable bulge in the middle of his thigh where the graft ran. The duplex ultrasound and CT angiography revealed a 22×34 mm pseudoaneurysm within the vein graft body, located away from the anastomoses while maintaining distal blood flow. Peripheral pulses showed a triphasic pattern, while the patient displayed no signs of infection or trauma. Open surgery involved excising the aneurysmal section containing organized thrombus and calcification, followed by end-to-end anastomoses of the graft ends. The patient experienced an uneventful recovery process with preserved limb blood flow. Discussion: Non-anastomotic vein graft pseudoaneurysms occur less than 0.1% of the time in grafts and manifest several years following surgery due to degenerative changes. True vein graft aneurysms affecting all vessel layers are sporadic and frequently associated with systemic aneurysmal conditions and atherosclerotic changes. The development of vein graft pseudoaneurysms results from prolonged arterial pressure contact, altered vein wall structures, and blood flow stress. Establishing a proper diagnosis through duplex and imaging tests enables healthcare professionals to choose the most appropriate management approach. Surgical excision of the graft and graft reconstruction is the definitive therapeutic approach for preventing rupture, although high-risk patients may receive endovascular stent graft exclusion. Autologous vein grafts require continuous lifetime monitoring because they can develop la

Early Arthroscopic Fixation of Low-Grade Juvenile Osteochondritis Dissecans With Bioabsorbable Pins Achieves Excellent Clinical and Imaging Outcomes in High-Demand Athletes.

Background: Background: Knee osteoarthritis (OA) is a leading cause of pain and disability among older adults, characterized by degenerative changes in joint cartilage and bone that impair function and quality of life. Despite a growing burden in aging populations, disparities persist in both disease experience and the quality of OA management delivered in community and clinical settings. Assessing disability and patient-reported quality of care is essential to improving management strategies and promoting functional independence in the geriatric population. Objective: To determine the level of disability and the quality of osteoarthritis care among geriatric patients with symptomatic knee OA and to examine gender-based differences in these outcomes. Methods: A cross-sectional study was conducted among 385 elderly participants (≥60 years) with symptomatic knee OA recruited from hospitals and clinics in Muridke and Gujranwala, Pakistan, in 2023. Disability was measured using the Knee Injury and Osteoarthritis Outcome Score (KOOS), and care quality was assessed with the Osteoarthritis Quality Indicator Questionnaire (OA-QI). Data were analyzed using SPSS version 24, with independent t-tests comparing mean scores between genders and Pearson correlation testing associations between OA-QI and KOOS domains. A p-value ≤ 0.05 was considered statistically significant. Results: Of 385 participants, 277 (71.9%) were female and 108 (28.1%) male. Females reported higher OA-QI scores (45.71 ± 3.33 vs. 44.93 ± 3.15, p = 0.036) and significantly higher KOOS Symptom scores (39.07 ± 11.19 vs. 35.91 ± 11.38, p = 0.014). Overall KOOS scores correlated positively with OA-QI (r = 0.43, p &lt; 0.001), indicating that higher quality of care was associated with reduced disability. The odds of symptomatic OA were 2.56 times higher in females than in males (95% CI: 1.87–3.51). Conclusion: Symptomatic knee osteoarthritis is more prevalent among older females, who nonetheless report better care quality and slightly improved functional outcomes. Enhanced adherence to evidence-based OA management correlates with better pain control, functional capacity, and quality of life. These findings underscore the importance of patient-centered, multidisciplinary approaches in geriatric knee OA care.

ABSTRACTBackgroundMutations in the desmin gene cause skeletal myopathies and cardiomyopathies. The objective of this study was to elucidate the molecular pathology induced by the expression of R405W mutant desmin in murine skeletal muscle.MethodsA comprehensive characterization of the skeletal muscle pathology in hetero‐ and homozygous R405W desmin knock‐in mice was performed. This included grip strength, blood acylcarnitine and amino acid, histological, ultrastructural, immunofluorescence, immunoblot, ribosomal stalling, RNA sequencing and proteomic analyses.ResultsBoth hetero‐ and homozygous R405W desmin knock‐in mice showed classical myopathological features of a myofibrillar myopathy with desmin‐positive protein aggregation, degenerative changes of the myofibrillar apparatus and mitochondrial alterations. Muscle weakness and increased blood concentrations of acylcarnitines and amino acids were only present in homozygous animals. During its translation, mutant desmin did not induce terminal ribosomal stalling. Analyses of RNA sequencing and proteomic data from soleus muscle of 3‐month‐old mice depicted 59 up‐ and 3 down‐regulated mRNAs and 101 up‐ and 18 down‐regulated proteins that were shared between the heterozygous and homozygous genotypes in the respective omics datasets compared to the wild‐type genotype. Combined analysis of the omics data demonstrated 187 significantly dysregulated candidates distributed across four groups of regulation. A down‐regulation on the mRNA and protein levels was observed for a multitude of mitochondrial proteins including essential proton gradient‐dependent carriers. Up‐regulation on both omics levels was present for the transcription factor Mlf1, which is a binding partner of protein quality control related Dnajb6. Down‐regulated on mRNA but up‐regulated on the protein level was the sarcomeric lesion marker Xirp2 (xin actin‐binding repeat‐containing protein 2), whereas Ces2c (acylcarnitine hydrolase) was regulated in the opposite way.ConclusionsThe present study demonstrates that the expression of mutant desmin results in a myofibrillar myopathy in hetero‐ and homozygous R405W desmin knock‐in mice. Combined morphological, transcriptomic and proteomic analyses helped decipher the complex pattern of early pathological changes induced by the expression of mutant desmin. Our findings highlight the importance of major mitochondrial alterations, including essential proton gradient‐dependent carriers as well as Dnajb6‐related protein quality control and Xin‐related myofibrillar damage, in the molecular pathogenesis of desminopathies.

Temporomandibular disorder presenting as chronic migraine; the diagnostic role of MRI and interdisciplinary evaluation: A clinical report.

Background Osteoarthritis (OA) is a prevalent degenerative joint disease lacking curative treatments. While moderate physical activity such as swimming has been demonstrated to decelerate disease progression, its applicability is limited for individuals unable to perform high-impact or weight-bearing exercises. This study aimed to evaluate whether hydrotherapy—a low-impact, aquatic-based intervention—exerts joint-protective effects comparable to those of swimming in a murine model of OA. Methods Male C57BL/6 mice were subjected to destabilization of the medial meniscus (DMM) surgery in the right knee to induce OA and were subsequently randomized into three groups (n = 16 per group): DMM group (control), Hydrotherapy, and Swimming. An additional sham-operated group (n = 16) was included for baseline comparisons. Mice in the intervention groups underwent respective exercise regimens (30 min/session, twice daily, 5 days/week) for 4 or 8 weeks. Histopathological analyses were performed to assess degenerative changes in subchondral bone, articular cartilage, and quadriceps muscle. Additionally, expression levels of key proteins involved in mechanotransduction and tissue remodeling were quantified. Results DMM surgery resulted in marked subchondral bone degeneration, cartilage matrix disruption, and quadriceps muscle atrophy. Neither hydrotherapy nor swimming attenuated subchondral bone degeneration. Both interventions mitigated muscle atrophy, potentially via modulation of integrin β1 signaling. Furthermore, hydrotherapy and swimming effectively preserved cartilage structure and suppressed extracellular matrix degradation. These chondroprotective effects are consistent with a reduction in peak joint loading during aquatic exposure and an associated attenuation of integrin αV and TGF-β/SMAD2/3 signaling, although causality was not directly tested in this study. Conclusion These findings demonstrate that hydrotherapy confers cartilage-protective benefits comparable to swimming in a mouse model of OA. Possibly through the modulation of mechanosensitive signaling pathways, hydrotherapy may represent a viable, non-pharmacological strategy for delaying OA progression, particularly in individuals with limited capacity for conventional physical exercise.

BackgroundRotator cuff tears are associated with significant morbidity, and retear rates after surgical repair remain high, largely due to chronic degenerative changes such as muscle atrophy and fatty infiltration. This study aims to evaluate the effects of locally injected adipose tissue-derived stem cells and orally administered N-acetylcysteine, individually and in combination, on tendon healing in a rabbit model of chronic rotator cuff rupture.MethodsThirty-two male New Zealand white rabbits were used as models of chronic rotator cuff tear, surgically established by detaching the supraspinatus tendon and delaying repair to create a chronic defect. The rabbits were divided into four groups: Group A (control, saline-treated), Group B (N-acetylcysteine-treated), Group C (adipose tissue-derived stem cells-treated), and Group D (combined adipose tissue-derived stem cells and N-acetylcysteine-treated). Chronic rotator cuff tear repairs were conducted after six weeks. Histological, immunohistochemical, and biomechanical assessments were performed 12 weeks post-repair. Key outcomes included collagen organization, fatty infiltration, type I collagen expression, and tensile strength.ResultsHistopathological analysis revealed significantly improved collagen fiber alignment, reduced fatty infiltration, and decreased inflammation in Groups C and D compared to Groups A and B (p < 0.001). Immunohistochemical analysis revealed higher Type I collagen reactivity in Groups C and D, with Group D exhibiting the highest reactivity (p < 0.001). Biomechanical testing confirmed significantly increased load to failure in Groups C and D, with Group D achieving the highest values (p < 0.001).ConclusionsAdipose tissue-derived stem cells and N-acetylcysteine independently promote tendon healing, with adipose tissue-derived stem cells showing superior effects on collagen organization and fatty infiltration reduction. Combined treatment with adipose tissue-derived stem cells and N-acetylcysteine demonstrated synergistic effects, resulting in optimal tendon regeneration and strength. These findings support the potential of adipose tissue-derived stem cells and N-acetylcysteine as complementary therapies for chronic rotator cuff injuries. Further research is warranted to explore their mechanisms of action and clinical applications.

The article presents the results of a study focused on assessing the characteristics and variability of pain intensity in servicemen with degenerative changes in the intervertebral discs of the lumbar spine, depending on their functional body position. The aim of the study was to conduct a quantitative evaluation of pain intensity using the Visual Analogue Scale (VAS) in servicemen with degenerative intervertebral disc changes during standing, sitting, and movement, in order to identify the patterns of pain manifestation and determine postural conditions associated with maximal discomfort. The study involved 21 servicemen aged 32–47 years, with body mass ranging from 67.6 to 106.4 kg and body height from 167.7 to 184.9 cm. Pain assessment was carried out in three functional positions: standing, sitting, and during movement, with data statistically analyzed using the Friedman and Wilcoxon tests. The results demonstrated significant differences in pain intensity depending on the body position (χ² = 6.53; df = 2; p = 0.038). The highest mean VAS value was observed in the standing position (5.60±0.92 cm), reflecting a more pronounced pain response likely caused by increased axial load on the lumbar spine. The sitting position showed slightly lower values (4.97±0.88 cm), while the lowest pain intensity was recorded during movement (4.86±0.60 cm), suggesting the beneficial role of dynamic activity in reducing discomfort. Pairwise comparisons confirmed statistically significant differences between standing and both sitting (p = 0.04) and movement (p = 0.02) conditions, whereas no significant difference was found between sitting and movement (p = 0.46). These findings indicate that the intensity of lumbar pain in servicemen with degenerative disc changes varies depending on posture, reaching its peak in static standing conditions and decreasing under dynamic loads. The study highlights the importance of considering positional factors when assessing pain and designing individualized rehabilitation programs. The results may serve as a scientific basis for optimizing rehabilitation and physical conditioning protocols aimed at maintaining spinal health and operational readiness among military personnel.