125 results on '"Ming Long Yeh"'
Search Results
2. Role of open cerclage wiring in patients with comminuted fractures of the femoral shaft treated with intramedullary nails
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Wei Ren Su, Kai-Lan Hsu, Fa-Chuan Kuan, Ming Long Yeh, Chih-Kai Hong, Hao-Chun Chuang, and Tzu-Hao Wang
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medicine.medical_specialty ,Nonunion ,Bone healing ,Diseases of the musculoskeletal system ,Bone Nails ,law.invention ,Intramedullary rod ,Fixation (surgical) ,law ,Medicine ,Humans ,Orthopedics and Sports Medicine ,In patient ,Fractures, Comminuted ,Retrospective Studies ,Fracture Healing ,Orthopedic surgery ,integumentary system ,business.industry ,Perioperative ,medicine.disease ,Surgery ,Fracture Fixation, Intramedullary ,Treatment Outcome ,RC925-935 ,Nail (fastener) ,business ,Femoral Fractures ,RD701-811 ,Research Article - Abstract
Introduction The role of open cerclage wiring in comminuted femoral shaft fracture treatment with intramedullary nails remains unclear. Here, we analyzed the effect of open cerclage wiring and the risk factors for nonunion after interlocking nailing in comminuted femoral shaft fracture treatment. We hypothesized that open cerclage wiring can be applied in patients with severe comminuted femoral shaft fractures without affecting bone healing. Patients and methods This retrospective cohort study used data from consecutive patients who underwent interlocking nail fixation of a comminuted femoral shaft fracture between January 1, 2009, and December 31, 2016. First, eligible patients were divided into the wire and no wire groups according to the surgical technique used, and their union rate was recorded. The patients were then divided into the union and nonunion groups, and their perioperative data were analyzed. Results In total, 71 comminuted femoral shaft fractures treated with interlocking nail fixation were included: 38 fractures (53.5%) augmented with the open wiring technique and 33 reduced with closed or mini-open techniques without wiring. The wire group demonstrated significant improvements in fracture reduction compared with the no wire group, whereas no significant difference was observed in the union rate between the wire and no wire groups (p = 0.180). Moreover, 46 (65%) of 71 fractures achieved union smoothly, and no significant difference was observed in any perioperative data between the union and nonunion groups. Discussion Augmentation with open cerclage wiring is indicated for comminuted femoral shaft fractures treated with intramedullary nails, even when the fragments are large or greatly displaced. Thus, open cerclage wiring can be used for fracture treatment without decreasing the union rate. more...
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- 2021
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3. Treatment of a rotator cuff tear combined with iatrogenic glenoid fracture and shoulder instability: A rare case report
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Wei-Hsing Chih, Wei Ren Su, Ming Long Yeh, Kuan-Kai Tung, Chen-Hao Chiang, and Ting-Chien Tsai
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musculoskeletal diseases ,medicine.medical_specialty ,Bursitis ,Glenoid fracture ,03 medical and health sciences ,Arthroscopy ,0302 clinical medicine ,Rare case ,Case report ,Medicine ,Manipulation ,Orthopedics and Sports Medicine ,Rotator cuff ,030222 orthopedics ,medicine.diagnostic_test ,business.industry ,Frozen shoulder ,030229 sport sciences ,medicine.disease ,musculoskeletal system ,Surgery ,medicine.anatomical_structure ,Fracture ,Iatrogenic ,Shoulder instability ,Fracture (geology) ,business - Abstract
BACKGROUND The brisement manipulation is an effective treatment for refractory shoulder stiffness. Rotator cuff tears can sometimes exist in combination with adhesive capsulitis. Arthroscopic capsular release combined with rotator cuff repair has achieved good outcomes in published reports. CASE SUMMARY We report the case of a patient with right shoulder pain for more than 1 year that was suspected to have adhesive capsulitis and a rotator cuff tear that was treated with brisement manipulation and arthroscopic management. An iatrogenic glenoid fracture with shoulder instability occurred during the manipulation. Arthroscopic treatment for fracture fixation, capsular release, and rotator cuff repair was performed, and the functional results are reported. CONCLUSION Arthroscopic fixation for iatrogenic glenoid fracture and repairing coexisting rotator cuff tear can provide the stability needed for early rehabilitation. more...
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- 2020
4. The Biomechanical Properties of a High-Tensile Strength Tape for Tendon Graft Fixation Using the Krackow Configuration
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Chen-Hao Chiang, Wei Ren Su, Miin-Jye Wen, Ming Long Yeh, Chih-Kai Hong, Yueh Chen, Kai-Lan Hsu, and Fa-Chuan Kuan
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Orthodontics ,Materials science ,Rehabilitation ,Public Health, Environmental and Occupational Health ,Physical Therapy, Sports Therapy and Rehabilitation ,Suture (anatomy) ,Sports medicine ,Ultimate tensile strength ,Cyclic loading ,Ultimate failure ,Original Article ,Orthopedics and Sports Medicine ,Biomechanical model ,Elongation ,RC1200-1245 ,Tendon graft ,Fixation (histology) - Abstract
Purpose To compare the biomechanical properties of a high-tensile strength suture with the high-tensile strength tape for tendon graft fixation. Methods A total of 24 porcine tendons were used and were randomly divided into 2 groups. Two kinds of suture materials, a braided nonabsorbable high-strength suture (group S) and a high-tensile strength tape (group T), were used to complete 3 pairs of Krackow stitches on the tendons. Each specimen was pretensioned to 100 N for 3 cycles, cyclically loaded from 50 to 200 N for 200 cycles, and finally loaded to failure. Elongation after cyclic loading, ultimate failure load, and the mode of failure were recorded. Results The elongation after cyclic loading between group S (26% ± 5%) and group T (24% ± 5%) were not significantly different (P = .378). The ultimate failure loads in group T (400 ± 38 N) were significantly greater than those in group S (358 ± 21 N) (P = .010). All specimens failed because of suture material breakage. Conclusions Compared with the braided nonabsorbable high-strength suture, the high-tensile strength tape had similar elongation values after cyclic loading, but significantly greater ultimate failure load in this porcine in vitro biomechanical model. Clinical Relevance A secure suture-tendon construct is especially important when a post-tie fixation technique is used because the mitigating construct may potentially lead to graft loosening and affect graft healing. more...
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- 2020
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5. The Double Krackow Suture Technique Does Not Offer a Significant Benefit Compared to the Krackow Suture Technique in Subpectoral Biceps Tenodesis Using a Double-Loaded Suture Anchor
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Yueh Chen, Chih-Kai Hong, Wei Ren Su, Fa Chuan Kuan, Che-Chia Hsu, Ming Long Yeh, and Kai Lan Hsu
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medicine.medical_specialty ,Swine ,Tenodesis ,medicine.disease_cause ,Biceps ,Weight-bearing ,Weight-Bearing ,03 medical and health sciences ,0302 clinical medicine ,Suture (anatomy) ,Suture Anchors ,medicine ,Animals ,Orthopedics and Sports Medicine ,Suture anchors ,Fixation (histology) ,030222 orthopedics ,Simple suture technique ,business.industry ,Suture Techniques ,030229 sport sciences ,Tendon ,Surgery ,medicine.anatomical_structure ,Models, Animal ,business ,Greater Tuberosity - Abstract
To compare the biomechanical properties of the double simple suture (DSS) technique, Krackow suture (KS) technique, and double Krackow suture (DKS) technique in subpectoral biceps tenodesis using a double-loaded suture anchor in a porcine tendon model.A total of 30 artificial composite (polymer and glass fiber) humeri and porcine flexor profundus tendons with diameter of 4.5 mm were used. The sample size was determined based on the results of the pilot study. Metallic suture anchors with double-loaded No. 2 braided sutures were inserted at the subpectoral tenodesis site, 5 cm from the superomedial corner of the greater tuberosity. Three suture techniques were used to fix the tendons: a DSS used as the control, a KS, and a DKS, which is an alternative tendon graft fixation technique. A preload of 5 N was applied for 2 minutes, followed by cyclic loading for 500 cycles ranging from 5 to 70 N; next, a load-to-failure test at 1 mm/s was performed.The KS (283.5 ± 57 N) and DKS (270.4 ± 50 N) groups had significantly greater ultimate failure loads as compared with the DSS group (84.1 ± 6.4 N) (P.001). Meanwhile, the peak displacement at failure loads in the KS group (9.3 ± 2.2 mm) and DKS group (7.8 ± 1.7 mm) were significantly smaller than that of the DSS group (11.3 ± 2.9 mm) (P = .015). Stiffness in the DSS group (36.4 ± 3.0 N/mm), KS group (39.6 ± 2.5 N/mm), and DKS group (36.9 ± 4.6 N/mm) was not significantly different (P = .125). All DSS constructs and 6 KS constructs failed with tendons being cut through by the sutures, whereas the other 4 KS constructs and all DKS constructs failed resulting from suture breakage.In this subpectoral biceps tenodesis model, both the KS technique and the DKS technique had similar time 0 biomechanical properties that were better than those of the double simple suture technique.A sturdy suture-tendon structure could prevent clinical failure of a subpectoral biceps tenodesis using a suture anchor. more...
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- 2020
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6. Biomechanical comparison between various screw fixation angles for Latarjet procedure: a cadaveric biomechanical study
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Kai-Lan Hsu, Ming-Long Yeh, Fa-Chuan Kuan, Chih-Kai Hong, Hao-Chun Chuang, Wei-Ming Wang, and Wei-Ren Su
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Joint Instability ,Shoulder Joint ,Bone Screws ,Cadaver ,Humans ,Orthopedics and Sports Medicine ,Surgery ,General Medicine ,Biomechanical Phenomena - Abstract
The Latarjet procedure is a reliable treatment for the management of anterior glenohumeral instability with glenoid bone loss. However, the biomechanical properties of different fixation angles between screw and glenoid surface (α angle) have rarely been studied. The aim of the study was to investigate and compare the fixation stability, failure load, and failure mechanism between different α angles for Latarjet procedures, which were performed on cadaver specimens.Twenty-four shoulder specimens (8 in each of 3 groups) were dissected free of all soft tissue, and a 25% glenoid defect was created. The coracoid process was osteomized and fixed with 2 screws at 3 different α angles: 0° (group A), 15° (group B), and 30° (group C). Specimens were mounted to a testing apparatus, and cyclic loading (100 cycles at 1 Hz) was applied with a staircase protocol (50, 100, 150, and 200 N). Gross graft displacement and interface displacement were measured. The ultimate failure loads and failure mechanisms were recorded.There was no significant difference in gross displacement under any cyclic load between 3 groups. However, a significant larger interface displacement was noted in group C than in group A in 150-N cyclic loading (P = .017). Under failure strength testing, all 24 specimens failed because of screw cutout from the glenoid, and the ultimate failure load was similar among the three groups.Compared with the 0° α angle, the displacement after cyclic loading did not significantly increase when the α angle was increased to 15° but significantly increased at 30° for Latarjet procedures, which were performed on cadaver specimens. The results suggest that surgeons should apply the screws as parallel as possible to the glenoid surface when performing the Latarjet procedure. Although mild deviation may not reduce fixation stability, α angles greater than 30° should be avoided. more...
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- 2021
7. Restoring Osteochondral Defects through the Differentiation Potential of Cartilage Stem/Progenitor Cells Cultivated on Porous Scaffolds
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Hsueh-Chun Wang, Tzu-Hsiang Lin, Che-Chia Hsu, and Ming-Long Yeh
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Adult ,Cartilage, Articular ,Male ,Bone Regeneration ,monophasic approach ,QH301-705.5 ,osteochondral tissue engineering ,migration ,Article ,Immunophenotyping ,Colony-Forming Units Assay ,Polylactic Acid-Polyglycolic Acid Copolymer ,Animals ,Humans ,Cell Lineage ,Biology (General) ,Cell Shape ,Cells, Cultured ,Aged ,Aged, 80 and over ,Tissue Scaffolds ,Stem Cells ,cartilage stem/progenitor cell ,Cell Differentiation ,General Medicine ,X-Ray Microtomography ,Middle Aged ,poly (lactic-co-glycolic acid) scaffold ,Rabbits ,Chondrogenesis ,Porosity - Abstract
Cartilage stem/progenitor cells (CSPCs) are cartilage-specific, multipotent progenitor cells residing in articular cartilage. In this study, we investigated the characteristics and potential of human CSPCs combined with poly(lactic-co-glycolic acid) (PLGA) scaffolds to induce osteochondral regeneration in rabbit knees. We isolated CSPCs from human adult articular cartilage undergoing total knee replacement (TKR) surgery. We characterized CSPCs and compared them with infrapatellar fat pad-derived stem cells (IFPs) in a colony formation assay and by multilineage differentiation analysis in vitro. We further evaluated the osteochondral regeneration of the CSPC-loaded PLGA scaffold during osteochondral defect repair in rabbits. The characteristics of CSPCs were similar to those of mesenchymal stem cells (MSCs) and exhibited chondrogenic and osteogenic phenotypes without chemical induction. For in vivo analysis, CSPC-loaded PLGA scaffolds produced a hyaline-like cartilaginous tissue, which showed good integration with the host tissue and subchondral bone. Furthermore, CSPCs migrated in response to injury to promote subchondral bone regeneration. Overall, we demonstrated that CSPCs can promote osteochondral regeneration. A monophasic approach of using diseased CSPCs combined with a PLGA scaffold may be beneficial for repairing complex tissues, such as osteochondral tissue. more...
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- 2021
8. Interlocking nailing of femoral shaft fractures with an extremely narrow medullary canal is associated with iatrogenic fractures
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Kai Lan Hsu, Wei Ren Su, Ming Long Yeh, Wei Lun Chang, Chih Kai Hong, Yuan Fu Liu, and Fa Chuan Kuan
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Adult ,Male ,medicine.medical_specialty ,Medullary cavity ,Femoral shaft ,Taiwan ,Bone Nails ,law.invention ,Intramedullary rod ,03 medical and health sciences ,Postoperative Complications ,Sex Factors ,0302 clinical medicine ,law ,medicine ,Humans ,Femur ,Intraoperative Complications ,Interlocking ,Retrospective Studies ,General Environmental Science ,Fixation (histology) ,030222 orthopedics ,integumentary system ,business.industry ,Femoral canal ,Implant failure ,030208 emergency & critical care medicine ,Retrospective cohort study ,Organ Size ,Fracture Fixation, Intramedullary ,Surgery ,medicine.anatomical_structure ,Fractures, Ununited ,General Earth and Planetary Sciences ,Female ,Risk Adjustment ,Diaphyses ,business ,Femoral Fractures - Abstract
Introduction Controversy exists regarding the use of reamed interlocking nailing in femoral shafts with extremely narrow medullary canals (diameter ≤ 9 mm). The aims of this study were to (1) investigate the association of age and sex on femoral canal diameter in patients with a simple femoral shaft fracture and (2) compare the outcomes and complications of interlocking nailing between wide and extremely narrow intramedullary canals. Patients and methods For the purposes of this retrospective cohort study, consecutive patients with simple femoral shaft fractures were recruited between January 2009 and December 2016. The patient demographic data were analyzed. Then, fractures treated with interlocking nailing were divided into the wide group (canal diameter > 9 mm) and narrow group. The primary outcome was union rate, and the secondary outcomes were complications such as thermal necrosis, fat embolism syndrome, iatrogenic fracture, and implant failure. Results This study included 340 femoral shaft fractures. The average canal diameter was 9.97 ± 1.79 mm, with significantly wider canals in men than in women. Overall, 289 of the patients had undergone interlocking nail fixation, and a similar union rate and complications were noted between the wide canal and narrow canal groups, with the exception of the incidence of iatrogenic fracture. Conclusions Femoral shaft fractures associated with extremely narrow medullary canals are more common in women than in men. There was a similar union rate found when using interlocking nailing in a femoral shaft fracture in cases with extremely narrow and wider canals. Iatrogenic fracture is the only significant risk when using interlocking nailing in femoral shafts with extremely narrow canals. more...
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- 2019
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9. Biomechanical properties of off-axis screw in Pauwels III femoral neck fracture fixation: Bicortical screw construct is superior to unicortical screw construct
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Wei Ren Su, Chih Kai Hong, Ming Long Yeh, Cheng Li Lin, Fa Chuan Kuan, and Kai Lan Hsu
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musculoskeletal diseases ,medicine.medical_treatment ,Bone Screws ,Osteotomy ,Models, Biological ,Femoral Neck Fractures ,Bone and Bones ,Fracture Fixation, Internal ,03 medical and health sciences ,0302 clinical medicine ,Materials Testing ,Fracture fixation ,Humans ,Medicine ,Ultimate failure ,Simulation Training ,General Environmental Science ,Femoral neck ,Orthodontics ,030222 orthopedics ,biology ,business.industry ,Biomechanics ,030208 emergency & critical care medicine ,equipment and supplies ,musculoskeletal system ,medicine.disease ,biology.organism_classification ,Biomechanical Phenomena ,Valgus ,medicine.anatomical_structure ,Torque ,Diastasis ,General Earth and Planetary Sciences ,Artificial Organs ,Stress, Mechanical ,business - Abstract
The purpose of this study is to determine the biomechanical properties of the bicortical off-axis screw fixation for stabilizing of Pauwels III femoral neck fractures compared with other fixation methods.Eighteen synthetic femurs (Sawbones Pacific Research Laboratories, Vashon, WA) were divided into three groups. The osteotomy was made vertically to mimic the Pauwels type III femoral neck fracture. Group A (n = 6) was fixed with traditional inverted triangle cannulated screws. Group B (n = 6) was fixed with a unicortical off-axis screw and two parallel cannulated screws. Group C (n = 6) was fixed with a bicortical off-axis screw and two parallel cannulated screws. Each group was tested with a nondestructive axial compression test at a 7° of valgus followed with 1000 cycles of cyclic loading test from 100 N to 1000 N. Finally, a destructive axial compression test was applied until catastrophic failure.The average axial stiffness from group A to group C was 856.5, 934, and 1340 N/mm, respectively. The average ultimate failure load from group A to group C was 2612.7, 2508.8, and 3706 N, respectively. Group C exhibited significantly greater axial stiffness and a higher ultimate failure load than the other two groups (P 0.05). Regarding the interfragmental displacement, the values from group A to group C were 0.41, 0.83, 0.36, respectively, and group B exhibited significantly larger fracture gap formation after the cyclic loading test.The results of this biomechanical study show statistically significant increases in axial stiffness and ultimate failure load for the off-axis screw placed in bicortical fashion. Once the off-axis screw was positioned unicortically, the largest fracture diastasis was observed as compared to the other two methods. more...
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- 2019
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10. Arthroscopic Rotator Cuff Repair Combined With Modified Superior Capsule Reconstruction as Reinforcement by the Long Head of the Biceps
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Leo Shaw, Chen Hao Chiang, Wei Hsing Chih, Ming Long Yeh, and Wei Ren Su
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Orthopedic surgery ,030222 orthopedics ,medicine.medical_specialty ,business.industry ,Capsule ,030229 sport sciences ,musculoskeletal system ,Biceps ,behavioral disciplines and activities ,Tendon ,Surgery ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,medicine ,Technical Note ,Tears ,Head (vessel) ,Orthopedics and Sports Medicine ,Rotator cuff ,Biceps tendon ,business ,Vascular supply ,RD701-811 - Abstract
In large or massive rotator cuff tears, successful repairs are difficult and complication rates are high, because the torn tendon is contracted and the superior capsule is disrupted. Recent studies have shown that superior capsule reconstruction (SCR) in massive irreparable rotator cuff tears results in better clinical scores and preserves stable glenohumeral stability without significant complications. In this article, we propose a simple, efficient SCR technique to reinforce the repair of large or massive rotator cuff tears. For this technique, the long head of the biceps tendon is used as a local autograft for the SCR, therefore eliminating comorbidities related to graft harvesting. The proximal part of the long head of the biceps tendon is transposed posteriorly and fixed onto the footprint as the SCR, which not only can maintain the stability of the glenohumeral joint, but also can preserve the vascular supply to help healing. more...
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- 2019
11. 'Flip lid' type of lateral tibia plateau fracture with a meniscus radial tear: A case report
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Chen Hao Chiang, Wei Ren Su, Wei Hsing Chih, Ming Long Yeh, Shu Fan Lin, and Wei Ho
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RD1-811 ,medicine.medical_treatment ,Open reduction and internal fixation ,Case Report ,Meniscus (anatomy) ,Critical Care and Intensive Care Medicine ,03 medical and health sciences ,0302 clinical medicine ,Tibial plateau fracture ,medicine ,Internal fixation ,Orthopedics and Sports Medicine ,Reduction (orthopedic surgery) ,Knee arthroscopy ,Lateral meniscus ,Arthrotomy ,Orthodontics ,030222 orthopedics ,medicine.diagnostic_test ,business.industry ,030208 emergency & critical care medicine ,Magnetic resonance imaging ,medicine.disease ,musculoskeletal system ,medicine.anatomical_structure ,Emergency Medicine ,Fracture (geology) ,Surgery ,Meniscus tear ,business - Abstract
Case A 45-year-old woman sustained a unique lateral tibia plateau fracture pattern with a vertically rotated fragment composed of an intact articular surface and subchondral bone. During open reduction and internal fixation (ORIF), a full thickness radial tear of the lateral meniscus was found, which was repaired under direct visualization through arthrotomy. At final follow-up, the patient regained pain-free activity with good meniscus healing, as confirmed with a second-look arthroscopic examination. Conclusion This case represents an undescribed fracture pattern that indicates an associated meniscus injury. A thorough evaluation, including Magnetic Resonance Imaging should be considered. One-stage ORIF followed with meniscus repair represents a good treatment option. more...
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- 2021
12. Does posterior configuration have similar strength as parallel configuration for treating comminuted distal humerus fractures? A cadaveric biomechanical study
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Fa Chuan Kuan, Cheng Li Lin, Kai Lan Hsu, Chien An Shih, Ming Long Yeh, Wei Ren Su, and Chih-Kai Hong
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medicine.medical_specialty ,Humeral Fractures ,Distal humerus ,Diseases of the musculoskeletal system ,Bending ,Comminuted fracture ,03 medical and health sciences ,Fracture Fixation, Internal ,0302 clinical medicine ,Rheumatology ,Fracture fixation ,Parallel plating ,Cadaver ,Medicine ,Humans ,Orthopedics and Sports Medicine ,030212 general & internal medicine ,Fractures, Comminuted ,Fixation (histology) ,Orthodontics ,030222 orthopedics ,Distal humeral fracture ,business.industry ,Research ,Stiffness ,Humerus ,Biomechanical study ,Sagittal plane ,Biomechanical Phenomena ,Posterior plating ,medicine.anatomical_structure ,RC925-935 ,Orthopedic surgery ,medicine.symptom ,business ,Cadaveric spasm ,Bone Plates - Abstract
Background The posterior plating technique could be used as a clinical alternative to parallel plating for treating comminuted distal humerus fractures (DHFs) successfully with good clinical results. However, the biomechanical characteristics for posterior fixation are still unclear. The purpose of this study is to evaluate the biomechanical properties of the posterior fixation and to make comparisons between the parallel and the posterior fixation systems. Materials and methods We performed a cadaveric biomechanical testing with two posterior plating systems (a posterior two plating and a single posterior pre-contoured Y plating system) and one parallel two plating system to treat AO/OTA type-C2.3 DHFs. Among three groups, we compared construct stiffness, failure strength, and intercondylar width changes after 5000-cycle fatigue loading and failure loads and failure modes after destructive tests in both the axial compression and (sagittal) posterior bending directions. The correlations between construct failure loads and bone marrow density (BMD) were also compared. Results In axial direction, there were no significant differences in the stiffness and failure load between the posterior and the parallel constructs. However, in sagittal direction, the two-plate groups (posterior two plating and parallel plating group) had significant higher stiffness and failure loads than the one-plate group (single posterior Y plating). There was no fixation failure after 5000-cyclic loading in both directions for all groups. Positive correlation was noted between BMD and failure loads on parallel fixation. Conclusions We found that when using two plates for treating comminuted DHFs, there were no significant differences in terms of most biomechanical measurements between posterior and parallel fixation. However, the single pre-contoured posterior Y plate construct was biomechanically weaker in the sagittal plane than the parallel and the posterior two-plate constructs, although there was no fixation failure after the fatigue test for all groups regardless of the fixation methods. Level of evidence Biomechanical study more...
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- 2021
13. Role of open cerclage wires used in patients with comminuted fractures of femoral shaft treated with intramedullary nails
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Tzu-Hao Wang, Hao-Chun Chuang, Fa-Chuan Kuan, Chih-Kai Hong, Ming-Long Yeh, Wei-Ren Su, and Kai-Lan Hsu
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integumentary system - Abstract
IntroductionThe role of open cerclage wiring in comminuted femoral shaft fracture treatment with intramedullary nails remains unclear. Here, we analyzed the effect of open cerclage wiring and the risk factors for nonunion after interlocking nailing in comminuted femoral shaft fracture treatment. We hypothesize that open cerclage wiring is applicable to patients with severe comminuted femoral shaft fractures without affecting bone healing.Patients and MethodsThis retrospective cohort study used data of consecutive patients who underwent interlocking nail fixation of a comminuted femoral shaft fracture between January 1, 2009, and December 31, 2016. First, eligible patients were divided into wire and no wire groups according to the surgical technique used and their union rate was recorded. The patients were then divided into union and nonunion groups and their perioperative data were analyzed.ResultsIn total, 71 comminuted femoral shaft fractures treated with interlocking nail fixation were included: 38 fractures (53.5%) augmented with the open wiring technique and 33 reduced with closed or mini–open wound without wiring. The wire group demonstrated significant improvements in fracture reduction compared with the no wire group, whereas no significant difference was observed in the union rate between the wire and no wire groups (p = 0.180). Moreover, 46 (65%) of 71 fractures united smoothly, and no significant difference was observed in any perioperative data between union and nonunion groups.DiscussionAugmented open cerclage wiring is indicated for comminuted femoral shaft fractures treated with intramedullary nails, even when the fragments are large or far displaced. Thus, open cerclage wiring can be used for fracture treatment, without decreasing the union rate. more...
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- 2021
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14. Acellular Porcine Cornea Produced by Supercritical Carbon Dioxide Extraction: A Potential Substitute for Human Corneal Regeneration
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Fan-Wei Tseng, Ming-Long Yeh, Chang-Min Liang, Ming-Cheng Tai, Periasamy Srinivasan, and Dar-Jen Hsieh
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Biocompatibility ,Swine ,medicine.medical_treatment ,Biocompatible Materials ,Blindness ,Cornea ,Corneal Transplantation ,In vivo ,medicine ,Animals ,Humans ,Corneal transplantation ,Decellularization ,Tissue Engineering ,Tissue Scaffolds ,Chemistry ,Regeneration (biology) ,Carbon Dioxide ,eye diseases ,In vitro ,Staining ,Ophthalmology ,Disease Models, Animal ,medicine.anatomical_structure ,sense organs ,Biomedical engineering - Abstract
PURPOSE The aim of this study was to develop a non-cytotoxic, biocompatible innovative acellular porcine cornea (APC) for corneal wound healing and corneal blindness treatment. METHODS APC was produced by using supercritical carbon dioxide (SCCO2) to decellularize the porcine cornea. Decellularization of the porcine cornea was examined by hematoxylin and eosin staining and 4,6-diamidino-2-phenylindole, dihydrochloride staining. The residual DNA content of APC was analyzed in comparison with the native porcine cornea. Virus inactivation up to at least 6 log10 was confirmed for the stepwise process of APC for 4 different model viruses. In addition, a series of in vitro and in vivo tests in accordance with ISO-10993 biocompatibility assay and animal performance tests were performed. RESULTS APC produced by the SCCO2 process revealed complete decellularization, without any residual non-collagenous proteins. The scanning electron microscopy structural features of the decellularized cornea were similar to those of human. APC was found to be nontoxic and exhibited excellent biocompatibility in both in vitro and in vivo studies. The animal performance test proved that APC exerted excellent adaptability on the cornea and no sign of irritation and good compatibility in lamellar corneal transplantation. CONCLUSIONS APC manufactured by SCCO2 technology revealed complete cells and non-collagenous protein removal compared with the Triton-sodium dodecyl sulfate decellularization process. APC showed excellent biocompatibility in rabbit lamellar corneal transplantation with a follow-up to 1 year. APC can be a potential substitute for human-donated cornea for corneal transplantation in the near future. more...
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- 2021
15. Modified Superior Capsule Reconstruction Using the Long Head of the Biceps Tendon as Reinforcement to Rotator Cuff Repair Lowers Retear Rate in Large to Massive Reparable Rotator Cuff Tears
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Leo Shaw, Hsiao Hsien Ting, Chang Hao Lin, Wei Hsing Chih, Chen Hao Chiang, Wei Ren Su, Ming Long Yeh, and Chao Ping Chen
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medicine.medical_specialty ,Visual analogue scale ,medicine.medical_treatment ,Tenotomy ,Elbow ,Rotator Cuff Injuries ,Tendons ,03 medical and health sciences ,Arthroscopy ,Rotator Cuff ,0302 clinical medicine ,Medicine ,Humans ,Orthopedics and Sports Medicine ,Rotator cuff ,Range of Motion, Articular ,Retrospective Studies ,030222 orthopedics ,medicine.diagnostic_test ,business.industry ,Shoulder Joint ,Capsule ,Magnetic resonance imaging ,030229 sport sciences ,Magnetic Resonance Imaging ,Surgery ,medicine.anatomical_structure ,Treatment Outcome ,Tears ,business ,Range of motion - Abstract
To retrospectively assess the clinical outcomes of the patients with large to massive reparable RCTs treated by arthroscopic rotator cuff repair (ARCR) combined with modified superior capsule reconstruction (mSCR) using the long head of biceps tendon (LHBT) as reinforcement with a minimum of 2 years of follow-up.We retrospectively evaluated 40 patients with large to massive reparable RCTs who underwent ARCR and mSCR (group I) between February 2017 and June 2018 (18 patients) or underwent ARCR and tenotomy of LHBT performed at the insertion site (group II) between January 2015 and January 2017 (22 patients). The pain visual analog score (VAS) was assessed preoperatively and 1, 3, 6, 12, 24 months postoperatively. American Shoulder and Elbow Surgeons (ASES) scores, the University of California, Los Angeles (UCLA) shoulder rating scale, and active range of motion (AROM) were assessed before surgery and 6, 12, and 24 months after surgery. The integrity of the rotator cuff and mSCR was evaluated using magnetic resonance images at 12 months postoperatively.After surgery, both groups had significantly improved in VAS, ASES, UCLA and AROM scores in the final follow-up. There were no significant between-group differences in the characteristics of the patients before surgery. Group I had improved pain relief at 1 month (P.001) and at 3 months (P.01) after surgery. For the AROM, group I (flexion, external rotation, internal rotation) demonstrated better improvement than group II 6 months after surgery (all P.05) and better internal rotation 12 and 24 months after surgery (all P.05). The mSCR survival rate was 94.4% (17/18). The retear rate of repaired rotator cuffs for groups I and II was 16.7% (3/18) and 40.9% (9/22), respectively, and the differences were significant (P.046).ARCR combined with mSCR using LHBT as reinforcement may lead to a lower retear rate and earlier functional recovery than conventional ARCR with tenotomy of LHBT for large to massive reparable RCTs.Level III, retrospective therapeutic comparative trial. more...
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- 2020
16. Comparison of changes in shoulder functions between biceps tenotomy and tenodesis in an animal model
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I-Ming Jou, Wei Ren Su, Ming Long Yeh, Florence L. Chiang, Chih-Hsun Chang, Ping-Hui Wang, and Chih-Kai Hong
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medicine.medical_specialty ,medicine.medical_treatment ,Tenotomy ,Rat model ,Tenodesis ,Physical Therapy, Sports Therapy and Rehabilitation ,Long head of biceps tendon ,Biceps ,Sham group ,03 medical and health sciences ,0302 clinical medicine ,Animal model ,medicine ,Orthopedics and Sports Medicine ,lcsh:Sports medicine ,030222 orthopedics ,business.industry ,Rehabilitation ,030229 sport sciences ,Functional outcome ,Stride length ,Surgical procedures ,Surgery ,Gait analysis ,Asymmetric index ,Original Article ,business ,lcsh:RC1200-1245 - Abstract
Objectives: Tenotomy and tenodesis of the long head of biceps tendon are effective pain-relieving treatments. However, there is no consensus on the functional outcome after these surgical procedures. We hypothesized that there would be no difference in ambulation parameters after recovery from the surgery between rats that underwent tenotomy versus tenodesis procedures. Methods: Twenty-four New Zealand rats were used and randomly divided into three groups. Each group received one of the following surgeries: tenotomy, tenodesis, and sham operation. A video-based walking track system was applied for gait analysis at day −1, 1, 3, 5, 7, 14 and 21 for each rat. Temporal and spatial parameters were obtained, and asymmetric index was calculated for each parameter. Results: Compared to the tenotomy and sham-operated groups, the rats in the tenodesis group had shorter stance phase, longer swing time, longer step length, smaller paw length, smaller intermediary toe-spread length, smaller toe-spread length, and larger foot angle right after the tenodesis procedure. After day 14, all parameters were equivalent to those of the sham-operated group. At the end of the study, there were no functional changes found in tenotomy and tenodesis groups compared with the sham-operated group and preoperative status. Conclusion: Transient functional alterations in temporal and spatial parameters are found after tenotomy and tenodesis in a rat model. The functional changes in the tenodesis group existed for a longer period than in tenotomy group; however, and all parameters showed no significant differences when compared with the sham group at the conclusion of the study. Keywords: Long head of biceps tendon, Tenotomy, Tenodesis, Gait analysis, Functional outcome, Asymmetric index more...
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- 2019
17. Intra-articular Injection of Platelet-Rich Plasma Is Superior to Hyaluronic Acid or Saline Solution in the Treatment of Mild to Moderate Knee Osteoarthritis: A Randomized, Double-Blind, Triple-Parallel, Placebo-Controlled Clinical Trial
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Chien Jen Hsu, Ming Long Yeh, Chia Chi Yang, Jenn Huei Renn, and Kuan Yu Lin
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Adult ,Male ,musculoskeletal diseases ,WOMAC ,Knee Joint ,medicine.medical_treatment ,Osteoarthritis ,Placebo ,Severity of Illness Index ,Injections, Intra-Articular ,law.invention ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Double-Blind Method ,Randomized controlled trial ,law ,Severity of illness ,Humans ,Medicine ,Orthopedics and Sports Medicine ,030212 general & internal medicine ,Hyaluronic Acid ,Saline ,Aged ,Aged, 80 and over ,030222 orthopedics ,Viscosupplements ,Platelet-Rich Plasma ,business.industry ,Middle Aged ,Osteoarthritis, Knee ,medicine.disease ,Radiography ,Clinical trial ,Treatment Outcome ,Anesthesia ,Platelet-rich plasma ,Female ,Saline Solution ,business - Abstract
To prospectively compare the efficacy of intra-articular injections of platelet-rich plasma (PRP) and hyaluronic acid (HA) with a sham control group (normal saline solution [NS]) for knee osteoarthritis in a randomized, dose-controlled, placebo-controlled, double-blind, triple-parallel clinical trial.A total of 87 osteoarthritic knees (53 patients) were randomly assigned to 1 of 3 groups receiving 3 weekly injections of either leukocyte-poor PRP (31 knees), HA (29 knees), or NS (27 knees). The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score and International Knee Documentation Committee (IKDC) subjective score were collected at baseline and at 1, 2, 6, and 12 months after treatment. Data were analyzed using generalized estimating equations.All 3 groups showed statistically significant improvements in both outcome measures at 1 month; however, only the PRP group sustained the significant improvement in both the WOMAC score (63.71 ± 20.67, increased by 21%) and IKDC score (49.93 ± 17.74, increased by 40%) at 12 months. For the intergroup comparison, except for the first month, there was a statistically significant difference between the PRP and NS groups in both scores throughout the study duration (regression coefficients of 8.72 [P = .0015], 7.94 [P = .0155], and 11.92 [P = .0014] at 2, 6, and 12 months, respectively, for WOMAC score, and 9.1 [P = .0001], 10.28 [P = .0002], and 13.97 [P.0001], respectively, for IKDC score). There was no significant difference in both functional outcomes between the HA and NS groups at any time point. Only the PRP group reached the minimal clinically important difference in the WOMAC score at every evaluation (15%, 21%, 18%, and 21% at 1, 2, 6, and 12 months, respectively) and the minimal clinically important difference in the IKDC score at 6 months (improvement of 11.6).Intra-articular injections of leukocyte-poor PRP can provide clinically significant functional improvement for at least 1 year in patients with mild to moderate osteoarthritis of the knee.Level I, randomized controlled single-center trial. more...
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- 2019
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18. Treating AO/OTA 44B lateral malleolar fracture in patients over 50 years of age: periarticular locking plate versus non-locking plate
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Ming Long Yeh, Po-Ting Wu, Chien-An Shih, Wei Ren Su, Chin-Li Lu, I-Ming Jou, and Pei-Yuan Lee
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Male ,Syndesmosis ,medicine.medical_specialty ,lcsh:Diseases of the musculoskeletal system ,Visual analogue scale ,Fibula fracture ,Radiography ,Outcomes ,Osteoarthritis ,Ankle Fractures ,Cohort Studies ,Fracture Fixation, Internal ,03 medical and health sciences ,0302 clinical medicine ,lcsh:Orthopedic surgery ,Ankle fracture ,Non-locking plate ,medicine ,Humans ,Orthopedics and Sports Medicine ,Aged ,Retrospective Studies ,Aged, 80 and over ,030203 arthritis & rheumatology ,030222 orthopedics ,business.industry ,Middle Aged ,medicine.disease ,Surgery ,lcsh:RD701-811 ,Exact test ,Treatment Outcome ,medicine.anatomical_structure ,Orthopedic surgery ,Female ,lcsh:RC925-935 ,Ankle ,Complication ,business ,Bone Plates ,Research Article ,Follow-Up Studies ,Locking plate - Abstract
Background The role of locking plate in lateral malleolar fracture fixation for the elderly remains unclear. The aim of our study is to compare radiological and functional outcomes in older patients (> 50 years) with AO/OTA 44B lateral malleolar fractures after locking plate (PLP) or one-third non-locking tubular plate (TP) lateral fixation. Methods We retrospectively reviewed the medical records of 72 patients (PLP group, 34 patients; TP group, 38 patients; mean age, 61.9 ± 7.6 years; range, 51–80 years; follow-up, 1 year). Patients with open fractures, syndesmosis injuries, and a previous ankle trauma or surgery were excluded. Demographic data, union rate, complications, radiographic outcomes, visual analog scale (VAS) scores, and foot and ankle outcome scores (FAOSs) between the groups were recorded and compared. We also investigated the association of clinical features with pain and function. Statistically, the Fisher’s exact test was used for categorical variables and the Mann-Whitney U test for the continuous variables. The final model for the multiple regression analysis was used to predict factors related to functional outcomes. Results There were no significant between-group differences in demographic data, complication rates, immediately postoperative distal fibula lengths, ankle osteoarthritis (OA) grades, talar tilt angles (TTAs) ≥ 2°, or reduction accuracy. All fractures achieved union. The PLP group had significantly lower rates of distal screw loosening, fibula shortening > 2 mm, OA grade progression, and TTAs ≥ 2°, and better FAOSs and VAS scores than was the case for the TP group after 1 year of follow-up (all p < 0.05). The severity of OA, TTA ≥ 2°, and distal screw loosening were positively associated with VAS scores, and negatively associated with FAOSs. Conclusions When treating AO/OTA 44B fractures in patients over 50 years of age, PLPs provided better VAS scores, FAOSs, and radiological outcomes, including less fibula shortening > 2 mm, less osteoarthritic (OA) ankle progression, less implant removal rate, and fewer TTAs ≥ 2° than was the case for TPs after a 1-year follow-up. Level of evidence Therapeutic level III more...
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- 2020
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19. Association Between Medial Displacement of the Middle Glenohumeral Ligament and Subscapularis Tear Severity
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Kai-Lan, Hsu, Hao-Chun, Chuang, Hao-Ming, Chang, Ming-Long, Yeh, Fa-Chuan, Kuan, Yueh, Chen, Chih-Kai, Hong, and Wei-Ren, Su
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Orthopedics and Sports Medicine - Abstract
Background: The intraoperative invisible middle glenohumeral ligament (MGHL) test has been shown to be associated with a subscapularis tendon retraction. However, the preoperative location of the MGHL and its association with subscapularis tear severity has not been evaluated. Purpose: To determine (1) the interrater reliability for identification and position of the MGHL, (2) any association between the MGHL position and subscapularis tears, and (3) the cutoff point at which MGHL position can predict subscapularis tear severity. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: The magnetic resonance imaging (MRI) scans and surgical records of 176 patients were retrospectively reviewed by 3 independent orthopaedists. MGHL's identification, level (its position on axial MRI), and medial retraction ratio (distance from the lesser tuberosity to the MGHL divided by the width of the glenoid) were documented, and the interobserver agreement of the 3 indices was assessed. We calculated the association between subscapularis tears and the MGHL level and medial retraction ratio. Receiver operating characteristic (ROC) curve analyses were conducted to establish the optimal threshold of the MGHL medial retraction ratio to predict subscapularis tear. Results: The MGHL was identified by at least 2 reviewers in 124 individuals (70.5%). The interobserver reliability was very good for MGHL identification (κ = 0.766), moderate for MGHL level (κ = 0.582), and excellent for MGHL medial retraction ratio (intraclass correlation coefficient = 0.848). A low, positive correlation between MGHL level and subscapularis tear severity was found (Somers d = 0.392, P < .001), as well as a significant association between the medial retraction ratio and Lafosse classification of subscapularis tear size ( P < .001). A medial retraction ratio of ≥1.25 had a sensitivity of 0.70, a specificity of 0.83, and a positive likelihood ratio of 4.20, with excellent accuracy (area under the ROC curve = 0.820) to predict severe subscapularis tear. Conclusion: The MGHL was identified in 70.5% of shoulder MRIs. The location of the MGHL on preoperative MRI, as described by its level and the medial retraction ratio, was significantly associated with subscapularis tear severity, and a medial retraction ratio of ≥1.25 was predictive of a severe subscapularis tear. more...
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- 2022
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20. A bilineage thermosensitive hydrogel system for stimulation of mesenchymal stem cell differentiation and enhancement of osteochondral regeneration
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Tzu-Hsiang Lin, Hsueh-Chun Wang, Meng-Chian Wu, Horng-Chaung Hsu, and Ming-Long Yeh
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Mechanics of Materials ,Mechanical Engineering ,Ceramics and Composites ,Industrial and Manufacturing Engineering - Published
- 2022
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21. Strengthening injectable thermo-sensitive NIPAAm-g-chitosan hydrogels using chemical cross-linking of disulfide bonds as scaffolds for tissue engineering
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A. Lee Miller, Yu Shiuan Cheng, Lichun Lu, Xifeng Liu, Ming Long Yeh, and Shu Wei Wu
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Polymers and Plastics ,Biocompatibility ,Cell Survival ,Acrylic Resins ,Biocompatible Materials ,macromolecular substances ,02 engineering and technology ,010402 general chemistry ,01 natural sciences ,Article ,Injections ,Chitosan ,Mice ,chemistry.chemical_compound ,Tissue engineering ,Materials Chemistry ,Animals ,Disulfides ,Cell Proliferation ,Carbodiimide ,Tissue Engineering ,Tissue Scaffolds ,Organic Chemistry ,Temperature ,technology, industry, and agriculture ,Biomaterial ,Hydrogels ,Dynamic mechanical analysis ,021001 nanoscience & nanotechnology ,0104 chemical sciences ,chemistry ,Chemical engineering ,Covalent bond ,Self-healing hydrogels ,NIH 3T3 Cells ,0210 nano-technology - Abstract
In the present study, we fabricated non-toxic, injectable, and thermo-sensitive NIPAAm-g-chitosan (NC) hydrogels with thiol modification for introduction of disulfide cross-linking strategy. Previously, NIPAAm and chitosan copolymer has been proven to have excellent biocompatibility, biodegradability and rapid phase transition after injection, suitable to serve as cell carriers or implanted scaffolds. However, weak mechanical properties significantly limit their potential for biomedical fields. In order to overcome this issue, we incorporated thiol side chains into chitosan by covalently conjugating N-acetyl-cysteine (NAC) with carbodiimide chemistry to strengthen mechanical properties. After oxidation of thiols into disulfide bonds, modified NC hydrogels did improve the compressive modulus over 9 folds (11.4 kPa). Oscillatory frequency sweep showed a positive correlation between storage modulus and cross-liking density as well. Additionally, there was no cytotoxicity observed to mesenchymal stem cells, fibroblasts and osteoblasts. We suggested that the thiol-modified thermo-sensitive polysaccharide hydrogels are promising to be a cell-laden biomaterial for tissue regeneration. more...
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- 2018
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22. Biomechanical Evaluation of a Transtendinous All-Suture Anchor Technique Versus Interference Screw Technique for Suprapectoral Biceps Tenodesis in a Cadaveric Model
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Wei Ren Su, Cheng Li Lin, Ming Long Yeh, Kai Lan Hsu, Fa Chuan Kuan, and Chih-Kai Hong
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Male ,Shoulder ,Shoulder surgery ,medicine.medical_treatment ,Bone Screws ,Tenodesis ,Biceps ,03 medical and health sciences ,0302 clinical medicine ,Cadaver ,Suture Anchors ,Tensile Strength ,Bicipital groove ,medicine ,Humans ,Ultimate failure ,Orthopedics and Sports Medicine ,Humerus ,Displacement (orthopedic surgery) ,Muscle, Skeletal ,Aged ,Orthodontics ,030222 orthopedics ,business.industry ,Suture Techniques ,030229 sport sciences ,Middle Aged ,musculoskeletal system ,Biomechanical Phenomena ,medicine.anatomical_structure ,Arm ,Cadaveric spasm ,business - Abstract
Purpose To compare the biomechanical properties of an transtendinous all-suture anchor technique with the commonly-accepted interference screw technique in a cadaveric model. Methods Sixteen fresh-frozen human cadaveric shoulders (mean age, 67.6 ± 5.8 years) were used and were randomly divided into 2 experimental long head of the biceps brachii (LHB) tenodesis groups (n = 8), namely transtendinous all-suture anchor technique and interference screw technique. The location of tenodesis was in the bicipital groove, 1 cm distal to the proximal border of the bicipital groove. Tensile force parallel to the longitudinal axis of the humerus was applied to each specimen. A preload of 5 N was applied for 2 minutes, followed by cyclic loading for 500 cycles from 5 to 70 N at 1 Hz; then, a load-to-failure test at 1 mm/s was performed. The ultimate failure load, stiffness, cyclic displacement, failure displacement, and failure modes were recorded. Results The transtendinous all-suture anchor technique provided similar ultimate failure load and stiffness as the interference screw technique. However, the cyclic and failure displacements of the transtendinous all-suture anchor technique were significantly greater than the interference screw technique ( P = .009 and .021, respectively). Six specimens in the transtendinous all-suture anchor group failed because of suture anchor pullout, while failure of the other 2 was caused by tendon tear; by contrast, all specimens in the interference screw group failed because of tendon tear. Conclusions The transtendinous all-suture anchor technique for LHB tenodesis offered equivalent ultimate failure load and stiffness but had significantly larger cyclic and failure displacement values when compared with the interference screw technique in this cadaveric biomechanical study. Clinical Relevance The transtendinous all-suture anchor technique is an alternative technique for suprapectoral LHB tenodesis; however, care should be taken because only time zero biomechanical data are available. more...
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- 2018
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23. A Biomechanical Evaluation of Various Double Krackow Suture Techniques for Soft-Tissue Graft Fixation
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Ping Hui Wang, Cheng Li Lin, Wei Ren Su, Ming Long Yeh, Chih-Kai Hong, and Fa Chuan Kuan
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Orthodontics ,030222 orthopedics ,Ultimate load ,Swine ,business.industry ,Suture Techniques ,030229 sport sciences ,Soft tissue graft ,Nonabsorbable suture ,Tendons ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,Suture (anatomy) ,Tensile Strength ,Models, Animal ,Ligament ,Animals ,Medicine ,Cyclic loading ,Ultimate failure ,Orthopedics and Sports Medicine ,business ,Fixation (histology) - Abstract
Purpose The purpose of this study was to compare the biomechanical properties among the different double Krackow suture techniques for tendon graft fixation. Methods Thirty porcine flexor profundus tendons were randomly divided into 3 groups of 10 specimens each. Three different double Krackow suture techniques were evaluated, namely, the McKeon's double Krackow (MDK) suture, Wilson's double Krackow (WDK) suture, and Ostrander's modified Krackow (OMK) suture. All suture configurations were completed with a braided nonabsorbable suture. Each suture-tendon construct was pretensioned to 100 N for 3 cycles, cyclically loaded from 50 to 200 N for 200 cycles, and then finally loaded to failure. Elongation after cyclic loading, ultimate load to failure, and the mode of failure were recorded for each specimen. Results There were significant differences in elongation after cyclic loading among the MDK suture (7.9 ± 3.6 mm, 14% ± 6%), WDK suture (11.6 ± 2.2 mm, 22% ± 3%), and OMK suture (9.6 ± 3.3 mm, 17% ± 6%; P = .018). In addition, although the post hoc analysis showed that elongation after cyclic loading in the MDK suture was significantly less than the WDK suture ( P = .004), ultimate failure load and cross-sectional area were not significantly different across the 3 groups. Conclusions In this porcine in vitro biomechanical study, the MDK suture had significantly smaller elongation after cyclic loading than the WDK suture; however, high elongation values may have a potential for risk of clinical laxity. The ultimate failure load was not different across the MDK, WDK, and OMK sutures. Clinical Relevance Smaller elongation during cyclic loading in a suture-tendon construct represents a lower possibility of tendon graft loosening after ligament reconstruction surgery. The double Krackow suture techniques are attractive options for tendon graft fixation in ligament reconstruction, and the MDK suture could possibly be the optimal choice among the double Krackow suture techniques. more...
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- 2018
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24. Irreducible Elbow Dislocation Associated with Hill–Sachs-like Lesion over the Capitellum
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Hung-Kai Weng, Wei Lun Chang, Kai Lan Hsu, Ming Long Yeh, and Wei Ren Su
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medicine.medical_treatment ,Geography, Planning and Development ,Elbow ,Case Report ,02 engineering and technology ,Avulsion fracture ,Management, Monitoring, Policy and Law ,Lesion ,Forearm ,lcsh:Orthopedic surgery ,020204 information systems ,0202 electrical engineering, electronic engineering, information engineering ,Medicine ,business.industry ,Anatomy ,Traction (orthopedics) ,medicine.disease ,Fracture dislocation ,lcsh:RD701-811 ,medicine.anatomical_structure ,Elbow dislocation ,020201 artificial intelligence & image processing ,Hill-Sachs lesions ,Dislocation ,medicine.symptom ,business ,Range of motion - Abstract
Irreducible dislocation of the elbow is an uncommon event. We present the case of a posterolateral elbow dislocation after a fall injury in a 67-year-old woman. A closed reduction performed in the emergency department was unsuccessful since the limited passive range of motion resulted in difficulty to perform longitudinal traction and flexion. Computed tomography images showed that the posterolateral aspect of the capitellum was impacted by the tip of the coronoid process, thus appearing similar to the Hill?Sachs lesion in the humeral head. Subsequent open reduction of the elbow revealed the dislocation to be irreducible since the tip of the coronoid process had wedged into a triangular Hill?Sachs-like lesion in the capitellum. The joint was reduced by providing distal traction on the forearm, and main fragments were disengaged using digital pressure. At the 3-month follow-up, the patient reported no dislocations, and had an acceptable range of motion. Thus, we propose that to avoid iatrogenic injury to the joint or other nearby structures, irreducible dislocations should not be subjected to repeated manipulation. more...
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- 2019
25. The effect of humeral-fenestration diameter in Outerbridge–Kashiwagi arthroplasty on failure load of the distal humerus: a cadaveric biomechanical study
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Wei Ren Su, Chih-Kai Hong, Cheng Li Lin, I-Ming Jou, Ming Long Yeh, Chih-Hsun Chang, and Chih-Hung Chang
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medicine.medical_specialty ,medicine.medical_treatment ,Elbow ,Osteoarthritis ,Arthroplasty ,03 medical and health sciences ,0302 clinical medicine ,Elbow Joint ,medicine ,Humans ,Orthopedics and Sports Medicine ,030212 general & internal medicine ,Orthodontics ,030222 orthopedics ,Universal testing machine ,business.industry ,General Medicine ,Humerus ,medicine.disease ,Biomechanical Phenomena ,Diaphysis ,medicine.anatomical_structure ,Orthopedic surgery ,Surgery ,Cadaveric spasm ,business ,Fenestration - Abstract
Outerbridge–Kashiwagi ulnohumeral arthroplasty is an effective method in treating elbow osteoarthritis; however, distal humerus fracture after surgery can become a critical issue. A previous biomechanical study has shown that the failure load of the distal humerus decreases after a fenestration, but the size of the fenestration hole has not yet been discussed. 32 fresh-frozen cadaveric distal humeri were obtained. Two drill sizes were chosen for fenestration: 12 and 15 mm in diameter. Two directions of force were applied with a materials testing machine for biomechanical testing: 5° flexion for axial loading and 75° flexion for anterior–posterior (AP) loading. Each specimen randomly received one of the two fenestration sizes, and force directions. All specimens were loaded to failure at a rate of 2 mm/min. The failure loads of the 12 and 15 mm groups were not significantly different in either axial loading(3886 ± 1271 N vs 4286 ± 901 N) or AP loading(2303 ± 803 N vs 1897 ± 357 N). All specimens loaded with axial force failed via the fenestration holes; however, during AP loading, some specimens failed through the fenestration holes, while others at diaphysis (p = 0.28). The failure load of distal humeri did not differ significantly after fenestration of 12 or 15 mm. The clinical relevance is that as the risk of distal humerus fracture is not exacerbated, a larger-size fenestration hole could be of help to improve the effectiveness of this surgical procedure. more...
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- 2018
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26. Hydrothermal treatment and butylphosphonic acid derived self-assembled monolayers for improving the surface chemistry and corrosion resistance of AZ61 magnesium alloy
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Tzer Min Lee, Ming Long Yeh, Chung Wei Yang, Da Jun Lin, and Cheng Liu
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Multidisciplinary ,Chemistry ,Science ,Alloy ,Self-assembled monolayer ,02 engineering and technology ,engineering.material ,010402 general chemistry ,021001 nanoscience & nanotechnology ,01 natural sciences ,Article ,0104 chemical sciences ,Corrosion ,Dielectric spectroscopy ,Chemical engineering ,Coating ,Monolayer ,engineering ,Medicine ,Surface layer ,Magnesium alloy ,0210 nano-technology - Abstract
The hydrothermal treatment followed by a self-assembled monolayer (SAM) of 1-butylphosphonic acid through the tethering by aggregation and growth (T-BAG) method was employed to produce protective surface coatings on the Mg-6Al-1Zn alloy (AZ61) for reducing the degradation rate in physiological environments. Potentiodynamic polarization measurements revealed that the organic self-assembled monolayer and Mg(OH)2 coating can further enhance the surface chemical stability and corrosion resistance of Mg alloys. SAM-treated Mg(OH)2 coatings can be served as a more passive surface layer as a result of their much higher charge transfer resistance and the presence of Warburg impedance in electrochemical impedance spectroscopy measurement. more...
- Published
- 2017
27. The relationship of the anterior articular capsule to the adjacent subscapularis: An anatomic and histological study
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C.-J. Lee, Florence L. Chiang, Chih-Kai Hong, Chih Han Chang, Ming Long Yeh, and Wei Ren Su
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Male ,musculoskeletal diseases ,Inferior margin ,medicine.medical_specialty ,Metaphysis ,Rotator Cuff ,03 medical and health sciences ,0302 clinical medicine ,Lesser tubercle ,Cadaver ,Superior margin ,Humans ,Medicine ,Orthopedics and Sports Medicine ,Humerus ,Aged ,030222 orthopedics ,Articular capsule of the knee joint ,Shoulder Joint ,business.industry ,030229 sport sciences ,Anatomy ,Middle Aged ,musculoskeletal system ,Tendon ,Surgery ,medicine.anatomical_structure ,Female ,business ,Cadaveric spasm ,Joint Capsule - Abstract
Introduction The purpose of this study was to delineate the anatomic relationship between the anterior articular capsule and the adjacent subscapularis by measuring the dimensions of the anterior articular capsule attachment and the subscapularis footprint on the humerus, as well as investigating the interface between the two structures. Materials and methods Three shoulder specimens underwent histological analysis; for histological analysis, cross-sections through the subscapularis-capsule complex were harvested at the tendinous and muscular insertion sites. The dimensions of the anterior articular capsule attachment and the subscapularis footprint (including the tendinous and muscular insertions) were measured in thirteen cadaveric shoulder specimens. Results Histologically, the articular capsule has thin and loosely arranged collagen fibers with many interspersing fibroblast nuclei, whereas the outer layer of the articular capsule blends into a layer of more loosely spaced and less organized collagen fibers. This interface between the subscapularis and the underlying articular capsule is filled with more loosely spaced and less organized collagen fibers. The macroscopic evaluation showed that the minimum articular capsule width (4.2 mm, SD 2.2 mm) was located at its initiation 4.9 mm (SD, 2.1 mm) inferior to the superior margin of the subscapularis; the corresponding subscapularis footprint width measured 10.1 mm (SD, 4.9 mm). The maximum articular capsule width was11.1 mm (SD, 3.7 mm) and was located 5 mm distal to the inferior margin of the tendinous footprint. The maximum subscapularis footprint width was 15.8 mm (SD, 2.9 mm); the corresponding articular capsule attachment measured 5.2 mm (SD, 1.8 mm). Conclusions Our results suggest that the anterior articular capsule attachment of the glenohumeral joint complements the footprint of the subscapularis and occupies a larger area of the lesser tubercle and metaphysis of the humerus than previously documented. The histological study confirms the presence of a demarcation between the subscapularis and articular capsule, specifically more significant at the region medial to the tendon insertion and at the muscular insertion of the subscapularis. more...
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- 2017
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28. Factors affecting the outcomes of modified tension band wiring techniques in transverse patellar fractures
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Ming Long Yeh, Kai Lan Hsu, Chyun-Yu Yang, Chih Wei Chang, and Wei Lun Chang
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Male ,Reoperation ,medicine.medical_specialty ,Bone Screws ,Knee Injuries ,Fracture Fixation, Internal ,Fractures, Bone ,03 medical and health sciences ,Fixation (surgical) ,Postoperative Complications ,0302 clinical medicine ,Risk Factors ,medicine ,Humans ,Kirschner wire ,030212 general & internal medicine ,Device Removal ,Aged ,Retrospective Studies ,General Environmental Science ,Fracture Healing ,Orthodontics ,030222 orthopedics ,Tension (physics) ,business.industry ,Tension band wiring ,Patella ,Middle Aged ,medicine.disease ,Surgery ,Transverse plane ,Treatment Outcome ,General Earth and Planetary Sciences ,Female ,Implant ,Patella fracture ,business ,Bone Wires - Abstract
Introduction Modified tension band wiring has been widely used to treat transverse patellar fractures. However, few studies have evaluated the clinical outcomes using different methods of Kirschner wire bending, location of the tension band, and depths of Kirschner wires. Thus, we tried to clarify these factors according to our clinical outcomes. Patients and methods This retrospective cohort study recruited consecutive patients underwent surgical fixation for patellar fractures using modified tension band technique between January 2010 and December 2015. Different factors in this procedure, including the bending manner of the Kirschner wires, their depth, and location of the tension band with respect to the superior and inferior border of the patella were recorded and analysed. The primary outcome was early loss of fixation. The secondary outcomes were minor loss of reduction, implant breakage, deep infection, and the need for implant removal. Results This study included 170 patients with patellar fractures. Regarding the bending method, similar results were obtained with bilaterally or proximally bent Kirschner wires. Regarding length, the tension band was placed closely (within 25% of the patella length) in 124 patients and distantly in 46 patients. The rates of loss of reduction and implant breakage were significantly higher in the distantly placed tension bands. Regarding depth, 37 patellar fractures were fixed with the Kirschner wires at the superficial one third of the patellae while the K- wires at the middle layer of patella were used in the remaining 133 patellar fractures. A significantly higher rate of minor loss of reduction was obtained using the superficial Kirschner wires. Conclusion The modified tension band technique for transverse patella fractures provides favourable clinical outcomes, with low failure (5%) and infection (2%) rates. Implant irritation is the major complication, and almost half of cases require implant removal. The location of the tension band with respect to the superior and inferior border of the patella plays an important role in clinical outcomes. Placing the wire close to the patella may prevent major loss of reduction and implant breakage. Superficially placed Kirschner wires also affect clinical outcomes by increasing the rate of minor loss of reduction. more...
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- 2017
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29. Development of a novel micro-textured surface using duplex surface modification for biomedical Mg alloy applications
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Truan-Sheng Lui, Hung Pang Lee, Da Jun Lin, Ming Long Yeh, and Fei Yi Hung
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Materials science ,Mechanical Engineering ,Alloy ,Metallurgy ,02 engineering and technology ,engineering.material ,010402 general chemistry ,021001 nanoscience & nanotechnology ,Condensed Matter Physics ,Electrochemistry ,01 natural sciences ,0104 chemical sciences ,Corrosion ,Mechanics of Materials ,Duplex (building) ,Etching (microfabrication) ,engineering ,Surface modification ,General Materials Science ,Development (differential geometry) ,Composite material ,0210 nano-technology ,Filopodia - Abstract
A duplex surface-modification technique that combines ultrasonic-assisted etching and the fluoride-conversion method was successively applied on the surface of a Mg alloy, and was called the MagNest surface. The results showed that the MagNest surface possessed bowl-like nest structures about 15–35 µm in diameter and 2–5 µm in depth. Electrochemical testing verified that the corrosion resistance was increased, indicating that corrosion was effectively inhibited by the surface modification. The MagNest surface also exhibited non-cytotoxicity for MG63 osteoblast-like cells, with most adhered MG63 cells rapidly extending their cell membrane and filopodia. This demonstrates the excellent cytocompatibility of this surface modification, and so constitutes a promising biodegradable material. more...
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- 2017
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30. Superior biomechanical properties and tying time with the modified Prusik knot and Wittstein suture loop to the Krackow stitch
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Cheng Li Lin, Chih-Kai Hong, Jui Ming Yang, Chen Hao Chiang, Yi Chuan Chou, Chien An Shih, Wei Ren Su, and Ming Long Yeh
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Time Factors ,Swine ,Interobserver reproducibility ,Tendons ,Random Allocation ,03 medical and health sciences ,0302 clinical medicine ,Knot (unit) ,stomatognathic system ,Load to failure ,Animals ,Cyclic loading ,Medicine ,Orthopedics and Sports Medicine ,Tendon graft ,Procedure time ,030222 orthopedics ,business.industry ,Suture Techniques ,030229 sport sciences ,General Medicine ,Anatomy ,Biomechanical Phenomena ,Knot tying ,Knot group ,Surgery ,business - Abstract
The purposes of the study were to compare (1) the biomechanical properties of the modified Prusik knot, Wittstein suture loop, and Krackow stitch fixation, and (2) the knot tying times for tendon graft fixation among the Krackow stitch, modified rolling hitch, modified Prusik knot, and Wittstein suture loop. First, 33 fresh-frozen porcine flexor profundus tendons were randomly divided into three groups of 11 specimens. The experimental procedure was designed to assess elongation of the suture-tendon construct across the modified Prusik knot, Wittstein suture loop, and the Krackow stitch. Multistranded nonabsorbable sutures were used. Each specimen was pre-tensioned to 100 N for three cycles, cyclically loaded to 200 N for 200 cycles, and finally loaded to failure. Elongation, load to failure, and failure mode of each specimen were recorded. Second, the knot tying times for modified rolling hitch, modified Prusik knot, Wittstein suture loop, and Krackow stitch were investigated. The measurements were taken on three different occasions to account for intraobserver repeatability and interobserver reproducibility. The elongation after cyclic loading of the modified Prusik knot (22 ± 6%), Wittstein suture loop (25 ± 2%) were significantly smaller than the Krackow stitch (31 ± 5%) (p = 0.001 and 0.003, respectively). The failure loads of three groups were not significantly from one another. Meanwhile, the Krackow stitch group (80.9 ± 16.7 s) had significantly longer average procedure time than the modified rolling hitch group (9.2. ± 1.9 s) (p more...
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- 2017
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31. Correlation between Anti-Corrosion Performance and Optical Reflectance of Nano Fluoride Film on Biodegradable Mg-Zn-Zr Alloy: a Non-Destructive Evaluation Approach
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Truan-Sheng Lui, Da Jun Lin, Hung Pang Lee, Ming Long Yeh, and Fei Yi Hung
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010302 applied physics ,Materials science ,Anti-corrosion ,Zr alloy ,02 engineering and technology ,021001 nanoscience & nanotechnology ,01 natural sciences ,chemistry.chemical_compound ,chemistry ,Non destructive ,0103 physical sciences ,Nano ,Electrochemistry ,Composite material ,0210 nano-technology ,Fluoride ,Optical reflectance - Published
- 2017
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32. Do Needleless Knots have Similar Strength as the Krackow Suture? An In Vitro Porcine Tendon Study
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Cheng Li Lin, I-Ming Jou, Ming Long Yeh, Ting-Hsuan Kuo, Wei Ren Su, and Chih-Kai Hong
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030222 orthopedics ,Future studies ,business.industry ,030229 sport sciences ,General Medicine ,Anatomy ,Cadaver model ,Tendon ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,Suture (anatomy) ,Load to failure ,Ultimate tensile strength ,medicine ,Ultimate failure ,Cyclic loading ,Orthopedics and Sports Medicine ,Surgery ,business ,Biomedical engineering - Abstract
Numerous needleless techniques for tendon graft fixation that feature several advantages have been reported. However, there are few studies that have compared the holding strength between the needleless techniques (rolling hitch and modified rolling hitch) and traditional suture methods. To compare the tendon graft-holding strength of the rolling hitch and modified rolling hitch with the Krackow stitch in an in vitro porcine biomechanical model. Thirty fresh-frozen porcine flexor profundus tendons were randomly divided into three groups of 10 specimens. The experimental procedure was designed to assess elongation of the suture-tendon construct across the needleless tendon-grasping techniques and the Krackow stitch. All suture configurations were completed with a braided nonabsorbable suture. Each tendon was pretensioned to 100 N for three cycles, cyclically loaded from 50 to 200 N for 200 cycles, and then finally loaded to failure. Elongation, load to failure, and mode of failure were recorded for each specimen. Five of the 10 rolling hitch specimens failed during cyclic loading. With the numbers available, elongation after cyclic loading was not different among the successful rolling hitch specimens (19% [1.19 cm/6.17 cm] ± 6%), modified rolling hitch fixations (19% [1.11 cm/ 5.93 cm] ± 6%), and Krackow stitch fixations (26% [1.41 cm/5.43 cm] ± 6%); ultimate failure loads also were not different among the rolling hitch fixations (316 ± 35 N), modified rolling hitch fixations (342 ± 14 N), and Krackow stitches (327 ± 33 N) with the numbers available. With the numbers available, the rolling hitch, modified rolling hitch, and Krackow stitch techniques were not different in terms of elongation after cyclic loading and to failure in this in vitro biomechanical evaluation. Based on the biomechanical properties from this in vitro animal study, the modified rolling hitch may be an attractive alternative for tendon graft fixation in ligament-reconstruction surgery. Future studies might consider further evaluating these needleless techniques in a cadaver model, in an in vivo animal model, and in an intraarticular model in which the testing is performed in the presence of synovial fluid. more...
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- 2017
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33. Response to comments on 'Interlocking nailing of femoral shaft fractures with an extremely narrow medullary canal is associated with iatrogenic fractures.'
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Fa Chuan Kuan, Kai Lan Hsu, Ming Long Yeh, Hao Chun Chuang, and Wei Ren Su
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medicine.medical_specialty ,Medullary cavity ,Femoral shaft ,business.industry ,Iatrogenic Disease ,Fracture Fixation, Intramedullary ,Surgery ,medicine ,Humans ,General Earth and Planetary Sciences ,Diaphyses ,Femur ,business ,Interlocking ,General Environmental Science - Published
- 2020
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34. Using Interconnected Knotless Anchor for Suprapectoral Biceps Tenodesis Could Offer Improved Biomechanical Properties in a Cadaveric Model
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Kai Lan Hsu, Yueh Chen, Wei Ren Su, Joe Zhi Yen, Fa Chuan Kuan, Miin-Jye Wen, and Ming Long Yeh
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Male ,Shoulder ,Shoulders ,Bone Screws ,Tenodesis ,Biceps ,Tendons ,03 medical and health sciences ,Random Allocation ,0302 clinical medicine ,Suture (anatomy) ,Shoulder Pain ,Suture Anchors ,Cadaver ,Medicine ,Ultimate failure ,Humans ,Orthopedics and Sports Medicine ,Displacement (orthopedic surgery) ,Orthopedic Procedures ,Muscle, Skeletal ,Fixation (histology) ,Aged ,Orthodontics ,030222 orthopedics ,Sutures ,business.industry ,Suture Techniques ,Stiffness ,030229 sport sciences ,Middle Aged ,Plastic Surgery Procedures ,Biomechanical Phenomena ,Arm ,medicine.symptom ,Cadaveric spasm ,business - Abstract
Purpose To compare the biomechanical characteristics of the interconnected knotless anchor (IKA) fixation with the double knotless anchor (DKA) and interference screw (IS) fixation in the suprapectoral biceps tenodesis. Methods In total, 24 fresh-frozen human cadaveric shoulders (mean age, 67.3 ± 6 years) were used for the study. All the specimens were randomly divided into 3 experimental biceps tenodesis groups (n = 8): IKA, DKA, and IS. After tenodesis, each specimen was preloaded at 5 N for 2 minutes, followed by a cyclic loading test from 5 to 70 N for 500 load cycles. Finally, a destructive axial load to failure test (1 mm/s) was performed. All the values, including ultimate failure load, stiffness, cyclic displacement, and mode of failure were evaluated. Results The IKA provided the highest construct stiffness (38.9 ± 7.7 N/mm) and ultimate failure load (288.3 ± 47.6 N), the results for which were statistically better than the corresponding results in the IS and DKA groups. In terms of cyclic displacement, there were no statistical differences among the 3 fixation constructs. The most common failure mode was biceps tendon tearing in IS group (7/8) and IKA group (8/8). In the contrast, suture slippage accounted for the most common failure mode in DKA. Conclusions In suprapectoral bicep tenodesis, IKA fixation appears to offer improved construct stiffness and ultimate failure load while maintaining comparable suture slippage as compared with IS fixation or DKA fixation in the current biomechanical study. Clinical Relevance The IKA fixation compares favorably with other techniques and could be an alternative clinical option for suprapectoral biceps tenodesis. more...
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- 2019
35. When deadman theory meets footprint decortication: a suture anchor biomechanical study
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Fa Chuan Kuan, Chih Kai Hong, Che-Chia Hsu, Wei Ren Su, Ping Hui Wang, Ming Long Yeh, and Kai Lan Hsu
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Suture anchor ,lcsh:Diseases of the musculoskeletal system ,Insertion angle ,medicine.medical_treatment ,Models, Biological ,Weight-Bearing ,Rotator Cuff ,lcsh:Orthopedic surgery ,Suture Anchors ,Tensile Strength ,Materials Testing ,medicine ,Ultimate failure ,Humans ,Orthopedics and Sports Medicine ,Rotator cuff ,Biomechanics ,Decortication ,Suture anchors ,Orthodontics ,business.industry ,Suture Techniques ,Synthetic bone ,Biomechanical Phenomena ,lcsh:RD701-811 ,medicine.anatomical_structure ,Surgery ,lcsh:RC925-935 ,business ,Greater Tuberosity ,Research Article - Abstract
Background The optimal insertion angle for suture anchor insertion has long been of great interest. Although greater tuberosity decortication is commonly performed during rotator cuff repair, the effect of decortication on the suture anchor insertion angle remains unclear. The purpose of this study was to compare the pullout strength of threaded suture anchors inserted at 45° and 90° in decorticated and non-decorticated synthetic bone models. Methods Two kinds of synthetic bones were used to simulate the decorticated and non-decorticated conditions, for which 40 metallic suture anchors were used. Anchors were inserted at 45° and 90° in both decorticated and non-decorticated models and tested under cyclic loading followed by load-to-failure testing. The number of completed cycles, ultimate failure load, and failure modes was recorded. Results In the decorticated model, the ultimate failure load of anchors inserted at 45° (67.5 ± 5.3 N) was significantly lower than that of anchors inserted at 90° (114.1 ± 9.8 N) (p more...
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- 2019
36. Intravenous Administration of Tranexamic Acid Significantly Improved Clarity of the Visual Field in Arthroscopic Shoulder Surgery. A Prospective, Double-Blind, and Randomized Controlled Trial
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Chih Kai Hong, Yuan Fu Liu, Yueh Chen, Fa Chuan Kuan, Ming Long Yeh, Wei Ren Su, and Kai Lan Hsu
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Male ,Shoulder surgery ,medicine.medical_treatment ,Analgesic ,Preoperative care ,law.invention ,Rotator Cuff Injuries ,03 medical and health sciences ,Arthroscopy ,0302 clinical medicine ,Randomized controlled trial ,Double-Blind Method ,law ,Preoperative Care ,medicine ,Humans ,Orthopedics and Sports Medicine ,Rotator cuff ,Prospective Studies ,Prospective cohort study ,030222 orthopedics ,Analgesics ,Pain, Postoperative ,medicine.diagnostic_test ,business.industry ,Shoulder Joint ,030229 sport sciences ,Middle Aged ,Antifibrinolytic Agents ,Drug Utilization ,medicine.anatomical_structure ,Tranexamic Acid ,Anesthesia ,Administration, Intravenous ,Female ,Visual Fields ,business ,Tranexamic acid ,medicine.drug - Abstract
Purpose To determine whether intravenous administration of tranexamic acid (TXA) before shoulder arthroscopic rotator cuff repair surgery can improve arthroscopy visual clarity. Methods This was a prospective, double-blind, randomized, and placebo-controlled study. From May 2016 to April 2018, patients requiring arthroscopic rotator cuff repair were enrolled and randomly assigned to either the TXA group. receiving 1000 mg of TXA intravenously 10 minutes before surgery. or the placebo group. receiving the same volume of plain saline. Patients with pre-existing liver/renal disease, coagulopathy, or concurrent use of anticoagulation medications were excluded. Visual clarity was rated using a Numeric Rating Scale from grade 1 (poor) to grade 3 (clear) every 15 minutes throughout the surgery. Secondary outcomes included estimated perioperative blood loss, operative time, degree of shoulder swelling, postoperative subjective pain score, inpatient duration, and associated comorbidities were recorded. Both parametric and nonparametric methods were used for the statistical analysis. Results In total, 72 patients were enrolled, 37 in the TXA group and 35 in the placebo group. The demographic data were similar between the 2 groups. Visual clarity was found to be significantly better in the TXA group, with a greater percentage of grade 3 vision clarity (53.7 ± 18.9 % vs 40.5 ± 22.1%, P = .036). The average visual score in the TXA group (2.5 ± 0.2) also was better than that of the control group (2.3 ± 0.3) (P = .048). The postoperative subjective pain score was significantly lower in the TXA group (3.0 ± 1.5) than in the control group (4.3 ± 2.0) (P = .009). In addition, postoperative analgesic usage was significant lower in the TXA groups (9.6 ± 9.7 morphine milligram equivalent) than in the control group (14.7 ± 13.4 morphine milligram equivalent) (P = .037). Other parameters, such as operative time, estimated perioperative blood loss, degree of shoulder swelling, and duration of inpatient stay were similar between the 2 groups. None of the patients developed complications after surgery. Conclusions Intravenous administration of TXA is an alternative way to improve visual clarity in arthroscopic shoulder surgery. It also reduces subjective pain and analgesic consumption in the early postoperative period without significant side effects. Level of Evidence Therapeutic studies level II. more...
- Published
- 2019
37. Characterization of a Sandwich PLGA-Gallic Acid-PLGA Coating on Mg Alloy ZK60 for Bioresorbable Coronary Artery Stents
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Ming Long Yeh, Hung Pang Lee, and Li Han Lin
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chemistry.chemical_element ,cardiovascular stents ,02 engineering and technology ,engineering.material ,010402 general chemistry ,lcsh:Technology ,01 natural sciences ,Dip-coating ,Article ,endothelialization ,chemistry.chemical_compound ,Coating ,Restenosis ,medicine ,General Materials Science ,Gallic acid ,callic acid ,Magnesium alloy ,lcsh:Microscopy ,anticorrosion ,lcsh:QC120-168.85 ,lcsh:QH201-278.5 ,lcsh:T ,dip coating ,Chemistry ,Magnesium ,magnesium alloy ,021001 nanoscience & nanotechnology ,medicine.disease ,0104 chemical sciences ,Endothelial stem cell ,PLGA ,lcsh:TA1-2040 ,engineering ,lcsh:Descriptive and experimental mechanics ,lcsh:Electrical engineering. Electronics. Nuclear engineering ,lcsh:Engineering (General). Civil engineering (General) ,0210 nano-technology ,lcsh:TK1-9971 ,Biomedical engineering - Abstract
Absorbable magnesium stents have become alternatives for treating restenosis owing to their better mechanical properties than those of bioabsorbable polymer stents. However, without modification, magnesium alloys cannot provide the proper degradation rate required to match the vascular reform speed. Gallic acid is a phenolic acid with attractive biological functions, including anti-inflammation, promotion of endothelial cell proliferation, and inhibition of smooth muscle cell growth. Thus, in the present work, a small-molecule eluting coating is designed using a sandwich-like configuration with a gallic acid layer enclosed between poly (d,l-lactide-co-glycolide) layers. This coating was deposited on ZK60 substrate, a magnesium alloy that is used to fabricate bioresorbable coronary artery stents. Electrochemical analysis showed that the corrosion rate of the specimen was ~2000 times lower than that of the bare counterpart. The released gallic acid molecules from sandwich coating inhibit oxidation by capturing free radicals, selectively promote the proliferation of endothelial cells, and inhibit smooth muscle cell growth. In a cell migration assay, sandwich coating delayed wound closure in smooth muscle cells. The sandwich coating not only improved the corrosion resistance but also promoted endothelialization, and it thus has great potential for the development of functional vascular stents that prevent late-stent restenosis. more...
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- 2020
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38. Osteochondral Tissue Regeneration Using a Tyramine-Modified Bilayered PLGA Scaffold Combined with Articular Chondrocytes in a Porcine Model
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Horng-Chaung Hsu, Wen Hui Cheng, Tzu Hsiang Lin, Hsueh Chun Wang, and Ming Long Yeh
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Cartilage, Articular ,bilayer ,Scaffold ,Compressive Strength ,Swine ,Biocompatible Materials ,02 engineering and technology ,tyramine ,lcsh:Chemistry ,chemistry.chemical_compound ,Polylactic Acid-Polyglycolic Acid Copolymer ,Articular cartilage repair ,lcsh:QH301-705.5 ,Spectroscopy ,Tissue Scaffolds ,Hyaline cartilage ,Photoelectron Spectroscopy ,PLGA ,General Medicine ,021001 nanoscience & nanotechnology ,Computer Science Applications ,medicine.anatomical_structure ,Models, Animal ,chondrocyte ,Collagen ,0210 nano-technology ,Porosity ,Surface Properties ,0206 medical engineering ,osteochondral regeneration ,Article ,Catalysis ,Chondrocyte ,Inorganic Chemistry ,Chondrocytes ,medicine ,Animals ,Regeneration ,Physical and Theoretical Chemistry ,Molecular Biology ,Endochondral ossification ,Tissue Engineering ,Regeneration (biology) ,Cartilage ,Organic Chemistry ,technology, industry, and agriculture ,Water ,020601 biomedical engineering ,chemistry ,lcsh:Biology (General) ,lcsh:QD1-999 ,Biomedical engineering - Abstract
Repairing damaged articular cartilage is challenging due to the limited regenerative capacity of hyaline cartilage. In this study, we fabricated a bilayered poly (lactic-co-glycolic acid) (PLGA) scaffold with small (200&ndash, 300 &mu, m) and large (200&ndash, 500 &mu, m) pores by salt leaching to stimulate chondrocyte differentiation, cartilage formation, and endochondral ossification. The scaffold surface was treated with tyramine to promote scaffold integration into native tissue. Porcine chondrocytes retained a round shape during differentiation when grown on the small pore size scaffold, and had a fibroblast-like morphology during transdifferentiation in the large pore size scaffold after five days of culture. Tyramine-treated scaffolds with mixed pore sizes seeded with chondrocytes were pressed into three-mm porcine osteochondral defects, tyramine treatment enhanced the adhesion of the small pore size scaffold to osteochondral tissue and increased glycosaminoglycan and collagen type II (Col II) contents, while reducing collagen type X (Col X) production in the cartilage layer. Col X content was higher for scaffolds with a large pore size, which was accompanied by the enhanced generation of subchondral bone. Thus, chondrocytes seeded in tyramine-treated bilayered scaffolds with small and large pores in the upper and lower parts, respectively, can promote osteochondral regeneration and integration for articular cartilage repair. more...
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- 2019
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39. Continuous Passive Motion Promotes and Maintains Chondrogenesis in Autologous Endothelial Progenitor Cell-Loaded Porous PLGA Scaffolds during Osteochondral Defect Repair in a Rabbit Model
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Nai Jen Chang, Horng-Chaung Hsu, Hsueh Chun Wang, Ming Long Yeh, and Tzu Hsiang Lin
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0301 basic medicine ,Cartilage, Articular ,Male ,Bone Regeneration ,PLGA scaffolds ,osteochondral tissue engineering ,02 engineering and technology ,Extracellular matrix ,lcsh:Chemistry ,chemistry.chemical_compound ,Tissue engineering ,Polylactic Acid-Polyglycolic Acid Copolymer ,lcsh:QH301-705.5 ,Spectroscopy ,Endothelial Progenitor Cells ,Tissue Scaffolds ,Chemistry ,General Medicine ,Immunohistochemistry ,Computer Science Applications ,PLGA ,embryonic structures ,epithelial progenitor cells ,cardiovascular system ,Rabbits ,Chondrogenesis ,Porosity ,continuous passive motion ,0206 medical engineering ,Endothelial progenitor cell ,Catalysis ,Continuous passive motion ,Article ,Inorganic Chemistry ,03 medical and health sciences ,parasitic diseases ,Animals ,Physical and Theoretical Chemistry ,Molecular Biology ,Tissue Engineering ,Regeneration (biology) ,Organic Chemistry ,technology, industry, and agriculture ,X-Ray Microtomography ,020601 biomedical engineering ,Transplantation ,030104 developmental biology ,lcsh:Biology (General) ,lcsh:QD1-999 ,human activities ,Biomedical engineering - Abstract
Continuous passive motion (CPM) is widely used after total knee replacement. In this study, we investigated the effect of CPM combined with cell-based construct-transplantation in osteochondral tissue engineering. We created osteochondral defects (3 mm in diameter and 3 mm in depth) in the medial femoral condyle of 36 knees and randomized them into three groups: ED (empty defect), EPC/PLGA (endothelial progenitor cells (EPCs) seeded in the poly lactic-co-glycolic acid (PLGA) scaffold), or EPC/PLGA/CPM (EPC/PLGA scaffold complemented with CPM starting one day after transplantation). We investigated the effects of CPM and the EPC/PLGA constructs on tissue restoration in weight-bearing sites by histological observation and micro-computed tomography (micro-CT) evaluation 4 and 12 weeks after implantation. After CPM, the EPC/PLGA construct exhibited early osteochondral regeneration and prevention of subchondral bone overgrowth and cartilage degeneration. CPM did not alter the microenvironment created by the construct, it up-regulated the expression of the extracellular matrix components (glycosaminoglycan and collagen), down-regulated bone formation, and induced the biosynthesis of lubricin, which appeared in the EPC/PLGA/CPM group after 12 weeks. CPM can provide promoting signals during osteochondral tissue engineering and achieve a synergistic effect when combined with EPC/PLGA transplantation, so it should be considered a non-invasive treatment to be adopted in clinical practices. more...
- Published
- 2019
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40. Different suture anchor fixation techniques affect contact properties in humeral greater tuberosity fracture: a biomechanical study
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Cheng Li Lin, Chih-Kai Hong, Chen Hao Chiang, Wei Ren Su, Fong-Chin Su, Yu Chih Wang, and Ming Long Yeh
- Subjects
Suture anchor ,medicine.medical_specialty ,Shoulder ,lcsh:Diseases of the musculoskeletal system ,Shoulders ,Fracture Fixation, Internal ,Rotator Cuff ,Rheumatology ,Suture Anchors ,medicine ,Cadaver ,Pressure ,Humans ,Orthopedics and Sports Medicine ,Humerus ,Orthodontics ,Double-row ,business.industry ,Suture Techniques ,Biomechanics ,Fixation (psychology) ,Middle Aged ,Pressure sensor ,Biomechanical Phenomena ,Humeral greater tuberosity fracture ,medicine.anatomical_structure ,Orthopedic surgery ,Shoulder Fractures ,Abduction ,lcsh:RC925-935 ,Contact pressure ,Cadaveric spasm ,Contact area ,business ,Research Article - Abstract
Background Suture anchor-based fixations of humeral greater tuberosity (GT) fractures have yielded good outcomes in both clinical and biomechanical studies. Be that as it may, the interface contact properties of these fixations have yet to be elaborated. In response, the contact characteristics of two double-row suture anchor fixations for the management of GT fracture were compared. Methods Two suture anchor-based fixation techniques, namely the Double-Row Suture Anchor Fixation (DR) and Suture-Bridge Technique (SB), were used to repair humeral GT fractures in 12 fresh-frozen human cadaveric shoulders. A Tekscan pressure sensor placed between the repaired tuberosity and humerus recorded continuous data points directly after repair and for 60 min at set time intervals. The constructs were then cyclically loaded until 100 N, and the shoulders tested at 0°, 30°, and 60° of abduction. Under an applied force, the contact pressure and contact area of the interface were determined. Results Although both fixation configurations showed decreased contact pressure and area over time, the SB group had higher contact pressure right after fixation and at all time points thereafter. In contrast, the DR group demonstrated significantly more contact pressure and area at each abduction position with the applied load. Nevertheless, contact pressure and area decreased in response to increasing abduction position for both fixation constructs. Conclusion Findings suggest that despite the SB construct having superior interface contact immediately after fixation, the DR construct offered better contact performance at all abduction angles with applied force. Level of evidence Basic Science, Biomechanics. more...
- Published
- 2018
41. Transforming growth factor beta 1 mediates the low-frequency vertical vibration enhanced production of tenomodulin and type I collagen in rat Achilles tendon
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Tsung Lin Cheng, Chau-Zen Wang, Chia-Hsin Chen, Ming Long Yeh, Yi Hsiung Lin, Chung-Hwan Chen, and Yan-Hsiung Wang
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0301 basic medicine ,Male ,Cell signaling ,Decorin ,Swine ,lcsh:Medicine ,Gene Expression ,Signal transduction ,Mechanotransduction, Cellular ,Biochemistry ,Stiffness ,Extracellular matrix ,Rats, Sprague-Dawley ,Tendons ,0302 clinical medicine ,Medicine and Health Sciences ,Myocyte ,Enzyme-Linked Immunoassays ,lcsh:Science ,Cells, Cultured ,Achilles tendon ,Multidisciplinary ,Frailty ,Myogenesis ,Chemistry ,Physics ,Classical Mechanics ,Signaling cascades ,musculoskeletal system ,Tendon ,Extracellular Matrix ,medicine.anatomical_structure ,Treatment Outcome ,Connective Tissue ,Models, Animal ,Physical Sciences ,Anatomy ,Type I collagen ,Research Article ,medicine.medical_specialty ,Cell biology ,Materials Science ,Material Properties ,Research and Analysis Methods ,Achilles Tendon ,Vibration ,Collagen Type I ,Transforming Growth Factor beta1 ,03 medical and health sciences ,Tendon Injuries ,Internal medicine ,medicine ,Genetics ,Animals ,Mechanical Properties ,Immunoassays ,Wound Healing ,lcsh:R ,Membrane Proteins ,Biology and Life Sciences ,Proteins ,030229 sport sciences ,Tenomodulin ,Rats ,Tenocytes ,030104 developmental biology ,Endocrinology ,Biological Tissue ,TGF-beta signaling cascade ,Immunologic Techniques ,lcsh:Q ,Collagens - Abstract
Vertical vibration (VV) is a whole-body vibration with mechanical loading that commonly used in rehabilitation and sports training to increase athlete muscle strength. Our previous study showed that low-magnitude, low-frequency VV at 8 Hz and 10 Hz increased myoblast myogenesis. Herein, we investigated whether a VV frequency at low-frequency 5-10 Hz has anabolic effects on tenocytes and improves tendon stiffness. In primary tenocytes, 10 Hz VV treatment increased the tenogenic marker gene expression of tenomodulin and extracellular matrix type I collagen but decreased decorin expression. qPCR and Enzyme-Linked Immunosorbent Assay (ELISA) results showed that TGF-β1 expression was increased in tenocytes after 3 days of 10 Hz VV treatment in vitro and in Achilles tendons after 3 weeks in vivo. Tenomodulin expression and Achilles tendon stiffness were significantly increased in Achilles tendons after 3 weeks in vivo. We also showed that the TGF-β1 receptor inhibitor SB431542 (10 μM) decreased the expression of tenomodulin and type I collagen but increased the decorin expression in tenocytes. These results indicated that the 10 Hz VV stimulated anabolic effects in tenocytes by increasing TGF-β1 expression that subsequently increases the expression of tenomodulin and type I collagen, and increased the Achilles tendon stiffness. This study provides insight into the low-frequency 10 Hz VV treatment improves tendon properties and can minimizes the risk of ligament/tendon reinjure during rehabilitation. more...
- Published
- 2018
42. Tailored coating chemistry and interfacial properties for construction of bioactive ceramic coatings on magnesium biomaterial
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Ming Long Yeh, Fei Yi Hung, Da Jun Lin, and Subhaini Jakfar
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Materials science ,Biocompatibility ,02 engineering and technology ,engineering.material ,010402 general chemistry ,01 natural sciences ,law.invention ,Corrosion ,Crystallinity ,Coating ,law ,lcsh:TA401-492 ,General Materials Science ,Calcination ,Ceramic ,Mechanical Engineering ,Metallurgy ,Biomaterial ,021001 nanoscience & nanotechnology ,0104 chemical sciences ,Chemical engineering ,Mechanics of Materials ,visual_art ,engineering ,visual_art.visual_art_medium ,lcsh:Materials of engineering and construction. Mechanics of materials ,0210 nano-technology ,Layer (electronics) - Abstract
Magnesium has the potential to replace materials currently used for medical implants, but its high corrosion rate limits its practical application. For the practical application purpose, a multilayer coating method that combined MgF2 layer and the sol–gel-synthesized hydroxyapatite (HA) layer on Mg substrate was proposed in this study to enhance corrosion resistance and biocompatibility. As characterized by SEM, TEM and electrochemical test, the MgF2 layer not only increases the interfacial stability during the coating process, but also provides a fluorine source that leads to the formation of low-solubility fluorine-substituted HA (FHA), resulting in excellent coating properties. The synthesized coatings were calcined at 400 and 500 °C, respectively, to control their crystallinity and impurities. The results show that the corrosion resistance of the specimens calcined at 500 °C was 11 times higher than that calcined at 400 °C. MG63 cells cultured on the optimized HA/MgF2 coatings were more viable than other surface. Furthermore, the spreading behavior of the cells was significantly higher on the optimized HA/MgF2 coatings. These results suggest that the designed-multilayer process and optimized calcination temperature can effectively control the coating chemistry and interfacial properties, which improves biocompatibility and allows for orthopedic application. Keywords: Magnesium-based materials, Biodegradability, Hydroxyapatite, Sol–gel process, Electrochemical corrosion, Cytocompatibility more...
- Published
- 2016
43. Intra-articular injection of N-acetylglucosamine and hyaluronic acid combined with PLGA scaffolds for osteochondral repair in rabbits
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Yi Ting Lin, Chih Chan Lin, Tzu Hsiang Lin, Ming Long Yeh, Hsueh Chun Wang, Nai Jen Chang, and Horng-Chaung Hsu
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Cartilage, Articular ,Male ,0301 basic medicine ,Medical Implants ,Physiology ,Osteoarthritis ,chemistry.chemical_compound ,0302 clinical medicine ,Animal Cells ,Hyaluronic acid ,Medicine and Health Sciences ,Hyaluronic Acid ,Connective Tissue Cells ,Mammals ,030222 orthopedics ,Multidisciplinary ,Tissue Scaffolds ,Chemistry ,Hyaline cartilage ,Eukaryota ,Animal Models ,PLGA ,medicine.anatomical_structure ,Experimental Organism Systems ,Connective Tissue ,Vertebrates ,Leporids ,Engineering and Technology ,Medicine ,Rabbits ,Anatomy ,Cellular Types ,Porosity ,Research Article ,Biotechnology ,medicine.medical_specialty ,Histology ,Science ,Bioengineering ,Context (language use) ,macromolecular substances ,Research and Analysis Methods ,Chondrocyte ,Acetylglucosamine ,03 medical and health sciences ,Chondrocytes ,Rheumatology ,Internal medicine ,Tissue Repair ,medicine ,Animals ,Bone regeneration ,Tissue Engineering ,Arthritis ,Cartilage ,Organisms ,technology, industry, and agriculture ,Biology and Life Sciences ,Cell Biology ,medicine.disease ,Biological Tissue ,030104 developmental biology ,Endocrinology ,Amniotes ,Animal Studies ,Medical Devices and Equipment ,Physiological Processes ,Polyglycolic Acid ,Articular Cartilage - Abstract
Repairing damaged articular cartilage is particularly challenging because of the limited ability of cartilage to perform self-repair. Intra-articular injections of N-acetylglucosamine (GlcNAc) comprise a method of repairing full-thickness articular cartilage defects in the rabbit knee joint model. To date, the effects of administration of GlcNAc and hyaluronic acid (HA) have been investigated only in the context of osteoarthritis treatment. Therefore, we evaluated the therapeutic effects of using cell-free porous poly lactic-co-glycolic acid (PLGA) graft implants and intra-articular injections of GlcNAc or HA in a rabbit model of osteochondral regeneration to investigate whether they have the potential for inducing osteochondral regeneration when used alone or simultaneously. Twenty-four rabbits were randomized into one of four groups: the scaffold-only group (PLGA), the scaffold with intra-articular injections of GlcNAc (PLGA+G) group, twice per week for four weeks; the scaffold with intra-articular injections of HA group (PLGA+HA) group, once per week for three weeks; and the scaffold with intra-articular injections of GlcNAc and HA (PLGA+G+HA) group, once per week for three weeks. Knees were evaluated at 4 and 12 weeks after surgery. At the end of testing, only the PLGA+G+HA group exhibited significant bone reconstruction, chondrocyte clustering, and good interactions with adjacent surfaces at 4 weeks. Additionally, the PLGA+G+HA group demonstrated essentially original hyaline cartilage structures that appeared to have sound chondrocyte orientation, considerable glycosaminoglycan levels, and reconstruction of the bone structure at 12 weeks. Moreover, the PLGA+G+HA group showed organized osteochondral integration and significantly higher bone volume per tissue volume and trabecular thickness. However, there were no significant differences between the PLGA+G and PLGA+HA groups except for gap formation on subchondral bone in the PLGA+G group. This study demonstrated that PLGA implantation combined with intra-articular injections of GlcNAc and HA allowed for cartilage and bone regeneration and significantly promoted osteochondral regeneration in rabbits without supplementation of exogenous growth factors. And the combination of this two supplements with PLGA scaffold could also prolong injection interval and better performance than either of them alone for the reconstruction of osteochondral tissue in the knee joints of rabbits. more...
- Published
- 2018
44. An in vivo study on endothelialized vascular grafts produced by autologous biotubes and adipose stem cells (ADSCs)
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Jun Neng Roan, Ming Long Yeh, Ying Chiang Ho, Yu Chieh Tseng, and Chih Chan Lin
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0301 basic medicine ,Pathology ,medicine.medical_specialty ,Materials science ,Intimal hyperplasia ,Endothelium ,Silicones ,Biomedical Engineering ,Biophysics ,Adipose tissue ,Biocompatible Materials ,Bioengineering ,030204 cardiovascular system & hematology ,Biomaterials ,Blood Vessel Prosthesis Implantation ,03 medical and health sciences ,0302 clinical medicine ,Tissue engineering ,Blood vessel prosthesis ,In vivo ,Materials Testing ,Adipocytes ,medicine ,Animals ,Bioprosthesis ,Tissue Engineering ,Polyethylene Terephthalates ,Stem Cells ,medicine.disease ,Blood Vessel Prosthesis ,030104 developmental biology ,medicine.anatomical_structure ,Endothelium, Vascular ,Rabbits ,Stem cell ,Subcutaneous tissue - Abstract
Currently, commercial synthetic vascular grafts made from Dacron and ePTFE for small-diameter, vascular applications (
- Published
- 2017
- Full Text
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45. Effect of injectable alpha calcium sulfate hemihydrate for repair of Hill-Sachs lesion in a rabbit model
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Hsin-Yi Liu, Ming-long Yeh, and Wei-Ren Su
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medicine.medical_specialty ,business.industry ,Calcium Sulfate Hemihydrate ,Rehabilitation ,Alpha (ethology) ,Physical Therapy, Sports Therapy and Rehabilitation ,02 engineering and technology ,010402 general chemistry ,021001 nanoscience & nanotechnology ,medicine.disease ,01 natural sciences ,0104 chemical sciences ,Surgery ,Hill–Sachs lesion ,Endocrinology ,Internal medicine ,medicine ,Rabbit model ,Orthopedics and Sports Medicine ,lcsh:Sports medicine ,0210 nano-technology ,business ,lcsh:RC1200-1245 - Published
- 2017
46. Phenolic Modified Ceramic Coating on Biodegradable Mg Alloy: The Improved Corrosion Resistance and Osteoblast-Like Cell Activity
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Ming Long Yeh, Hung Pang Lee, and Da Jun Lin
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Materials science ,Biocompatibility ,Alloy ,Oxide ,chemistry.chemical_element ,02 engineering and technology ,engineering.material ,010402 general chemistry ,01 natural sciences ,lcsh:Technology ,Article ,Corrosion ,chemistry.chemical_compound ,biocompatibility ,Coating ,Mg alloy ,ceramics coating ,molecular grafting ,General Materials Science ,Gallic acid ,lcsh:Microscopy ,Magnesium ion ,lcsh:QC120-168.85 ,lcsh:QH201-278.5 ,Magnesium ,lcsh:T ,Metallurgy ,021001 nanoscience & nanotechnology ,0104 chemical sciences ,Chemical engineering ,chemistry ,lcsh:TA1-2040 ,engineering ,lcsh:Descriptive and experimental mechanics ,lcsh:Electrical engineering. Electronics. Nuclear engineering ,0210 nano-technology ,lcsh:Engineering (General). Civil engineering (General) ,lcsh:TK1-9971 - Abstract
Magnesium alloys have great potential for developing orthopedic implants due to their biodegradability and mechanical properties, but the rapid corrosion rate of the currently-available alloys limits their clinical applications. To increase the corrosion resistance of the substrate, a protective ceramic coating is constructed by a micro-arc oxidation (MAO) process on ZK60 magnesium alloy. The porous ceramic coating is mainly composed of magnesium oxide and magnesium silicate, and the results from cell cultures show it can stimulate osteoblastic cell growth and proliferation. Moreover, gallic acid, a phenolic compound, was successfully introduced onto the MAO coating by grafting on hydrated oxide and chelating with magnesium ions. The gallic acid and rough surface of MAO altered the cell attachment behavior, making it difficult for fibroblasts to adhere to the MAO coating. The viability tests showed that gallic acid could suppress fibroblast growth and stimulate osteoblastic cell proliferation. Overall, the porous MAO coating combined with gallic acid offered a novel strategy for increasing osteocompatibility. more...
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- 2017
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47. Mechanical performances of endovascular aneurysm repair strategies with main aortic and chimney grafts
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Ming Long Yeh, Wei Ling Chen, Chung Dann Kan, and Bing-Feng Huang
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medicine.medical_specialty ,medicine.medical_treatment ,030204 cardiovascular system & hematology ,Endovascular aneurysm repair ,03 medical and health sciences ,Aortic aneurysm ,Blood Vessel Prosthesis Implantation ,0302 clinical medicine ,Aneurysm ,medicine ,Humans ,In patient ,030212 general & internal medicine ,Aortic graft ,business.industry ,Open surgery ,Endovascular Procedures ,Stent ,X-Ray Microtomography ,medicine.disease ,Surgery ,surgical procedures, operative ,Stents ,business ,Abdominal surgery ,Aortic Aneurysm, Abdominal - Abstract
The use of endovascular aneurysm repair (EVAR) strategies for the treatment of complex aortic pathologies is a major area of investigation in modern surgery. EVAR strategies using fenestrated or branched devices provide alternatives to open surgery for patients with aortic pathologies with visceral branch involvement, but their applications have some major limitations. To extend endovascular repair to patients whose anatomy is unfit for branched or fenestrated stent grafts or open repair, parallel graft techniques using chimney grafts (CGs) have been proposed. Several recent series have confirmed that the midterm durability of CGs is similar to that of other endovascular repair techniques. However, the risk of a persistent type 1 endoleak, or gutter endoleak, is a major concern for their further application. In addition, the combinations of CGs with various brands of main aortic graft (MAG) that are applicable for use in patients remain unclear. This study aimed to determine the radial forces developed by different brands of MAG and their effects on CGs, and the real gutter condition produced between the CGs and main stent grafts. more...
- Published
- 2017
48. Preparation of acellular scaffold for corneal tissue engineering by supercritical carbon dioxide extraction technology
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Shu Wei Wu, Dar Jen Hsieh, Wen Hsin Chang, Yi Hsun Huang, Fan Wei Tseng, I. Chen Peng, and Ming Long Yeh
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0301 basic medicine ,Scaffold ,Materials science ,Lysis ,Biocompatibility ,Swine ,medicine.medical_treatment ,Biomedical Engineering ,02 engineering and technology ,Biochemistry ,Biomaterials ,Cornea ,Corneal Transplantation ,03 medical and health sciences ,Tissue engineering ,medicine ,Animals ,Humans ,Molecular Biology ,Corneal transplantation ,Decellularization ,Tissue Engineering ,Tissue Scaffolds ,Extraction (chemistry) ,General Medicine ,Carbon Dioxide ,021001 nanoscience & nanotechnology ,eye diseases ,030104 developmental biology ,medicine.anatomical_structure ,Heterografts ,sense organs ,Rabbits ,0210 nano-technology ,Biotechnology ,Biomedical engineering - Abstract
In this study, we developed a novel method using supercritical carbon dioxide (SCCO 2 ) to prepare acellular porcine cornea (APC). Under gentle extraction conditions using SCCO 2 technology, hematoxylin and eosin staining showed that cells were completely lysed, and cell debris, including nuclei, was efficiently removed from the porcine cornea. The SCCO 2 -treated corneas exhibited intact stromal structures and appropriate mechanical properties. Moreover, no immunological reactions and neovascularization were observed after lamellar keratoplasty in rabbits. All transplanted grafts and animals survived without complications. The transplanted APCs were opaque after the operation but became transparent within 2 weeks. Complete re-epithelialization of the transplanted APCs was observed within 4 weeks. In conclusion, APCs produced by SCCO 2 extraction technology could be an ideal and useful scaffold for corneal tissue engineering. Statement of significance We decellularized the porcine cornea using SCCO 2 extraction technology and investigated the characteristics, mechanical properties, and biocompatibility of the decellularized porcine cornea by lamellar keratoplasty in rabbits. To the best of our knowledge, this is the first report describing the use of SCCO 2 extraction technology for preparation of acellular corneal scaffold. We proved that the cellular components of porcine corneas had been efficiently removed, and the biomechanical properties of the scaffold were well preserved by SCCO 2 extraction technology. SCCO 2 -treated corneas maintained optical transparency and exhibited appropriate strength to withstand surgical procedures. In vivo, the transplanted corneas showed no evidence of immunological reactions and exhibited good biocompatibility and long-term stability. Our results suggested that the APCs developed by SCCO 2 extraction technology could be an ideal and useful scaffold for corneal replacement and corneal tissue engineering. more...
- Published
- 2017
49. Characterization and evaluation of the differentiation ability of human adipose-derived stem cells growing in scaffold-free suspension culture
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Ming Long Yeh, Jyun Yi Wu, Chau-Zen Wang, Chia-Hsin Chen, Mei-Ling Ho, Chung-Hwan Chen, Yan-Hsiung Wang, Pei Jung Chou, and Je Ken Chang
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Cancer Research ,Cell Survival ,Immunology ,Cell ,Cell Culture Techniques ,Tetrazolium Salts ,Biology ,Regenerative medicine ,Chondrocytes ,Tissue engineering ,Osteogenesis ,Adipocytes ,medicine ,Humans ,Immunology and Allergy ,Viability assay ,Genetics (clinical) ,Cell Proliferation ,Transplantation ,Adipogenesis ,Osteoblasts ,Tissue Engineering ,Cell growth ,business.industry ,Stem Cells ,Cell Differentiation ,Cell Biology ,Chondrogenesis ,Cell biology ,Biotechnology ,medicine.anatomical_structure ,Oncology ,Stem cell ,business - Abstract
Background aims Human adipose-derived stem cells (hADSCs) have become a popular stem cell source because of their abundant supplies, high differentiation ability and the fact that they present few ethical concerns. Suspension culture, a type of three-dimensional culture, is a more suitable model for mimicking cell-cell and cell–extracellular matrix interactions than is two-dimensional monolayer culture. The aim of this study was to determine the effects of suspension culture on the viability and differentiation potential of hADSCs. Methods Different densities of hADSCs were cultured in ultra-low–attachment surface plates. The morphology and mean diameter of the resultant aggregates were determined by means of microscopy. The viability of the aggregates was evaluated with the use of 3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium, inner salt, lactate dehydrogenase and live/dead assays. To detect osteogenesis, chondrogenesis and adipogenesis in hADSCs in suspension culture, cell aggregates were stained to determine cell function, and the expression of specific markers was evaluated through the use of real-time reverse transcriptase–polymerase chain reaction. Results The hADSCs remained viable in suspension culture and formed cell aggregates. The diameter of the majority of the aggregates was in the range of 50–200 μm, regardless of cell density. The aggregation of the hADSCs served to maintain cell survival. In addition, the results of the histomorphometric and gene expression analyses showed that the hADSCs were more efficiently induced to differentiate into osteoblasts, chondrocytes and adipocytes in suspension culture than in two-dimensional monolayer culture. Conclusions Suspension culture can be used to maintain cell viability and contributes to the effective differentiation of hADSCs, providing an alternative cell growth strategy for application to stem cell–based regenerative medicine. more...
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- 2014
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50. The F-actin and adherence-dependent mechanical differentiation of normal epithelial cells after TGF-β1-induced EMT (tEMT) using a microplate measurement system
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Ming Jer Tang, Wen Tai Chiu, Ming Long Yeh, T. H. Wu, C. H. Chen, and Y. W. Chiou
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Cytochalasin D ,Epithelial-Mesenchymal Transition ,Materials science ,Cellular differentiation ,Cell ,Biomedical Engineering ,Transforming Growth Factor beta1 ,Mice ,Cell Movement ,Cell Adhesion ,medicine ,Animals ,Epithelial–mesenchymal transition ,Cell adhesion ,Molecular Biology ,Actin ,Mechanical Phenomena ,biology ,Cadherin ,Cell Differentiation ,Epithelial Cells ,Vinculin ,Cadherins ,Actins ,Biomechanical Phenomena ,Cell biology ,medicine.anatomical_structure ,biology.protein ,Microtechnology ,Transforming growth factor - Abstract
The epithelial to mesenchymal transition (EMT) is known to involve several physiological and pathological phenomena. In this study, we utilized a microplate measurement system (MMS) approach based on the deflection of a flexible micro-cantilever to measure cell stiffness (in Pa) and adhesion force (in nN) of a single cell during EMT with nN resolution. Our results demonstrated that after transforming growth factor-β1 (TGF-β1) induced EMT (tEMT), NMuMG cells became stiffer due to thicker and more abundant F-actin and displayed stronger vinculin accumulation after long-term cell-substrate adhesion. The MMS could distinguish differences in compressive stiffness (219 ± 10 and 287 ± 14 Pa), tensile stiffness (114 ± 14 and 132 ± 12 Pa), and adhesion force (150 ± 42 and 192 ± 31 nN) between cells before and after tEMT. However, without proper development of the F-actin structure and adequate adherent time, the mechanical differences were diminished. After tEMT, the cells with increased stiffness and a cell-substrate adhesion force benefited by migrating more rapidly and had more invasiveness. Thus, this technology has the potential to benefit research focused on cancer diagnosis, drug development, and cell-substrate interactions. more...
- Published
- 2014
- Full Text
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