Tung-Yang Yu

Reproducibility of sonographic measurement of thickness and echogenicity of the plantar fascia.

To evaluate the intra‐ and interrater reliability of ultrasonographic measurements of the thickness and echogenicity of the plantar fascia.

Decreased proliferation of aging tenocytes is associated with down-regulation of cellular senescence-inhibited gene and up-regulation of p27.

Symptomatic tendinopathy tends to be age‐related. However, the molecular mechanisms of ageing and its effects on tenocyte proliferation and cell cycle progression are unknown. We examined tenocytes from Achilles tendons in rats from three age groups (young, 2 months; middle‐aged, 12 months, and near senescence, 24 months). Tenocyte proliferation was assessed by 3‐[4,5‐dimethylthiazol‐2‐yl]‐2,5‐diphenyltetrazolium bromide (MTT) assay and flow cytometry. Senescence‐associated β‐galactosidase (SA β‐gal) staining was performed in all groups of tenocytes. mRNA and protein expression of cellular senescence‐inhibited gene (CSIG) and p27 was measured by reverse transcription‐polymerase chain reaction (RT‐PCR) and Western blot, respectively. The results of MTT assay revealed that tenocyte proliferation decreased with age (p < 0.05). Cell cycle progression was arrested at G0/G1 phase in senescent tenocytes. More senescent tenocytes expressed SA β‐gal than young tenocytes did. By RT‐PCR and Western blot analysis, the gene and protein expression of CSIG was found to be down‐regulated, whereas that of p27 was up‐regulated with age. In conclusion, the proliferation of tenocytes declines with age and is associated with the down‐regulation of CSIG and up‐regulation of p27.

The effects of aging on quantitative sonographic features of rotator cuff tendons

Grayscale analysis is a practical, objective, and easy way to quantify echogenicity during ultrasonography. The purpose of the current study was to measure the changes in thickness and echogenicity that result from aging of the rotator cuff and long head of the biceps tendons.

Platelet-rich plasma increases proliferation of tendon cells by modulating Stat3 and p27 to up-regulate expression of cyclins and cyclin-dependent kinases

To investigate effects of platelet‐rich plasma on tendon cell proliferation and the underlying molecular mechanisms.

Sonographic measurements of the thickness of the soft tissues of the interscapular region in a population of normal young adults

Background. To use sonography (US) to measure the interscapular soft‐tissue thickness and to determine any correlation with anthropometric indices.

Platelet rich plasma releasate promotes proliferation of skeletal muscle cells in association with upregulation of PCNA, cyclins and cyclin dependent kinases

Abstract Platelet rich plasma (PRP) contains various cytokines and growth factors which may be beneficial to the healing process of injured muscle. The purpose of this study is to investigate the effect and molecular mechanism of PRP releasate on proliferation of skeletal muscle cells. Skeletal muscle cells intrinsic to Sprague–Dawley rats were treated with PRP releasate. Cell proliferation was evaluated by 3-[4,5-Dimethylthiazol- 2-yl]-2,5-diphenyltetrazolium bromide (MTT) assay and immunocytochemistry with Ki-67 stain. Flow cytometric analysis was used to evaluate the cell cycle progression. Western blot analysis was used to evaluate the protein expressions of PCNA, cyclin E1, cyclin A2, cyclin B1, cyclin dependent kinase (cdk)1 and cdk2. The results revealed that PRP releasate enhanced proliferation of skeletal muscle cells by shifting cells from G1 phase to S phase and G2/M phases. Ki-67 stain revealed the increase of proliferative capability after PRP releasate treatment. Protein expressions including cyclin A2, cyclin B1, cdk1, cdk2 and PCNA were up-regulated by PRP releasate in a dose-dependent manner. It was concluded that PRP releasate promoted proliferation of skeletal muscle cells in association with the up-regulated protein expressions of PCNA, cyclin A2, cyclin B1, cdk1 and cdk2.

Platelet rich plasma promotes skeletal muscle cell migration in association with up‐regulation of FAK, paxillin and F‐actin formation

Platelet rich plasma (PRP) contains various cytokines and growth factors which may be beneficial to the healing process of injured muscle. The aim of this study was to investigate the effect and molecular mechanism of PRP on migration of skeletal muscle cells. Skeletal muscle cells intrinsic to Sprague–Dawley rats were treated with PRP. The cell migration was evaluated by transwell filter migration assay and electric cell‐substrate impedance sensing. The spreading of cells was evaluated microscopically. The formation of filamentous actin (F‐actin) cytoskeleton was assessed by immunofluorescence staining. The protein expressions of paxillin and focal adhesion kinase (FAK) were assessed by Western blot analysis. Transfection of paxillin small‐interfering RNA (siRNAs) to muscle cells was performed to validate the role of paxillin in PRP‐mediated promotion of cell migration. Dose‐dependently PRP promotes migration of and spreading and muscle cells. Protein expressions of paxillin and FAK were up‐regulated dose‐dependently. F‐actin formation was also enhanced by PRP treatment. Furthermore, the knockdown of paxillin expression impaired the effect of PRP to promote cell migration. It was concluded that PRP promoting migration of muscle cells is associated with up‐regulation of proteins expression of paxillin and FAK as well as increasing F‐actin formation.

Comparative Effectiveness of Nonoperative Treatments for Chronic Calcific Tendinitis of the Shoulder: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials

OBJECTIVE To investigate the effectiveness of various nonoperative treatments for chronic calcific tendinitis of the shoulder, a systematic review and network meta-analysis of randomized trials was performed to evaluate changes in pain reduction, functional improvements in patients with calcific tendinitis, and the ratio of complete resolution of calcific deposition. DATA SOURCES Studies were comprehensively searched, without language restrictions, on PubMed, Embase, Cochrane Controlled Trials Register, the Cochrane, and other databases. The reference lists of articles and reviews were cross-checked for possible studies. STUDY SELECTION Randomized controlled trials from before August 2016 were included. Study selection was conducted by 2 reviewers independently. DATA EXTRACTION The quality of studies was assessed and data extracted by 2 independent reviewers. Disagreements were settled by consulting a third reviewer to reach a consensus. DATA SYNTHESIS Fourteen studies with 1105 participants were included in the network meta-analysis that used a random-effect model to investigate the mean difference of pooled effect sizes of the visual analog scale, Constant-Murley score, and the ratio of complete resolution of calcific deposition on native radiographs. CONCLUSIONS The present network meta-analysis demonstrates that ultrasound-guided needling (UGN), radial extracorporeal shockwave therapy (RSW), and high-energy focused extracorporeal shockwave therapy (H-FSW) alleviate pain and achieve complete resolution of calcium deposition. Compared with low-energy focused extracorporeal shockwave therapy, transcutaneous electrical nerve stimulation, and ultrasound therapy, H-FSW is the best therapy for providing functional recovery. Physicians should consider UGN, RSW, and H-FSW as alternative effective therapies for chronic calcific tendinitis of the shoulder when initial conservative treatment fails.

Platelet-Rich Plasma Releasate Promotes Regeneration and Decreases Inflammation and Apoptosis of Injured Skeletal Muscle:

Background: Platelet-rich plasma (PRP) contains various cytokines and growth factors that may be beneficial to the healing process of injured muscle. Based on the authors’ previous study, PRP releasate can promote proliferation and migration of skeletal muscle cells in vitro, so animal studies are performed to support the use of PRP to treat muscle injury in vivo. Purpose: To investigate the effect of PRP releasate on regeneration of injured muscle, as well as its effect on inflammatory reaction and cell apoptosis, in the early stages of the muscle-healing process. Study Design: Controlled laboratory study. Methods: The gastrocnemius muscles of Sprague-Dawley rats were injured by partial transverse incision and then treated with PRP releasate. Hematoxylin and eosin stain was used to evaluate the healing process of injured muscle at 2, 5, and 10 days after injury. TUNEL assay was used to evaluate the cell apoptosis of injured muscle after PRP releasate treatment. Immunohistochemistry was used to stain the CD68-positive cells during the healing process. Muscle contractile properties, including fast-twitch and tetanic strength, were evaluated by electric stimulation. Results: The results revealed that PRP releasate treatment could enhance the muscle-healing process and decrease CD68-positive cells and apoptotic cells. Furthermore, the tetanic strength was significantly higher in injured muscle treated with PRP releasate. Conclusion: In conclusion, PRP releasate could enhance the healing process of injured muscle and decrease inflammatory cell infiltration as well as cell apoptosis. Clinical Relevance: PRP promotes skeletal muscle healing in association with decreasing inflammation and apoptosis of injured skeletal muscle. These findings provide in vivo evidence to support the use of PRP to treat muscle injury.

Gender-Related Effect of Aging on the Sonographic Appearance of Plantar Fascia

Abstract Objectives: To investigate the association between demographic variables [especially age] and the sonographic appearance of the plantar fascia [PF]. Methods: Twenty-six healthy volunteers [52 feet, age 24–79 years] without inferior heel pain were recruited. The thickness of the PF of the participants was measured in sonographic examination. The mean grey level in the region of interest in the sonogram of each PF was calculated using image processing software. Pearson’s correlation and stepwise regression analyses were performed between demographic variables and sonographic measures. Results: The mean thickness of the PF was 0.319 ± 0.059 cm for men and 0.309 ± 0.093 cm for women. Stepwise regression analysis showed that age is an independent predictor of the thickness of the PF, and age and gender are independent predictors of echogenicity of the PF. Pearson’s correlation analysis showed significant positive correlations between age and thickness of the PF [r = 0.538] and between gender [male/female = 0/1] and echogenicity of the PF [r = 0.437]. A negative correlation between age and echogenicity of the PF [r = −0.344] was also shown. We divided the subjects into two gender-based groups and found significant correlations between age and sonographic measures only in the female group. Conclusions: The thickness of the PF increases and the echogenicity of the PF decreases with age. Although the echogenicity of the PF is higher in women than in men, the PF of women shows a greater association with aging.