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Jie K, Liang J, Xu J, Zou Y, Li B, Tan Y, Zhang H, Zhu Y. Changes in clinical outcomes and alignment of the ipsilateral knee and ankle after supramalleolar osteotomy in patients with varus osteoarthritis of the ankle: a short-term follow-up study. Arch Orthop Trauma Surg 2024; 144:161-170. [PMID: 37789151 DOI: 10.1007/s00402-023-05079-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 09/17/2023] [Indexed: 10/05/2023]
Abstract
PURPOSE The purpose of this study was to investigate the changes in clinical outcomes and alignment of the ipsilateral knee and ankle in patients with varus ankle osteoarthritis after supramalleolar osteotomy (SMO). METHODS We retrospectively reviewed 23 patients (24 ankles) with Takakura II, IIIa and IIIb ankle osteoarthritis treated with SMO between May 2017 and March 2022. The radiologic parameters of ankles contained medial distal tibial angle (TAS), tibiotalar angle (TT), tibial lateral surface (TLS), tibial plafond inclination (TPI) and talar inclination (TI). The radiologic parameters of knees contained medial proximal tibial angle (MPTA), joint line convergence angle (JLCA), the knee joint line orientation relative to ground (G-KJLO) and WBL. Hip-knee-ankle angle (HKA) was also collected. The Takakura system was used for evaluating the ankle osteoarthritis and the Kellgren-Lawrence (KL) system was used for evaluating the knee osteoarthritis. Clinical evaluation of the ankle joints contained American Orthopedic Foot and Ankle Society (AOFAS), range of motion (ROM) and visual analogue scale (VAS). Clinical evaluation of the knee joints contained Japanese Orthopaedic Association Scores (JOA), ROM, VAS. RESULTS The mean follow-up times were 20.3 ± 7.3 months (range 12-38). According to the radiologic evaluation, the TAS increased from preoperative 84.7° ± 2.0° to 91.2° ± 1.8° at the last follow-up (P < 0.001). The TPI and TI decreased from 4.4° ± 4.2° and 11.0° ± 5.2° to 0.1° ± 4.7° and 4.1° ± 4.8° (P < 0.001 for both). The TT angel improved from 9.5° ± 4.1° to 4.9° ± 3.3° (P < 0.001). No significant differences were found regarding MPTA, JLCA, G-KJLO, knee WBL and HKA (P > 0.05 for all). The Takakura stage improved after SMO (P < 0.001) whilst the KL stage maintains the similar lever (P > 0.05). According to the clinical evaluation, the AOFAS significantly increased from 67.5 ± 10.6 to 88.5 ± 9.3 and the VAS of the ankle decreased from 4.7 ± 1.6 to 1.2 ± 1.1, whilst there were no changes on VAS and even the JOA and knee ROM after SMO (P > 0.05 for all). CONCLUSIONS SMO can alleviate the symptoms of varus ankle osteoarthritis and delay the time for ankle replacement or arthrodesis by redistributing the abnormal stress of the ankle and restoring the congruence of the tibiotalar joint. In addition, it did not induce the clinical symptoms of knee without compromising lower limb alignment or knee joint line orientation in the short term. LEVEL OF EVIDENCE Level IV case series.
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Affiliation(s)
- Ke Jie
- Foshan Hospital of Traditional Chinese Medicine, 6 Qinren Road, Foshan, 528000, Guangdong, China
| | - Jinjie Liang
- Foshan Hospital of Traditional Chinese Medicine, 6 Qinren Road, Foshan, 528000, Guangdong, China
| | - Jingcheng Xu
- Foshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Chinese Medicine, 6 Qinren Road, Foshan, 528000, Guangdong, China
| | - Yunxuan Zou
- Foshan Hospital of Traditional Chinese Medicine, 6 Qinren Road, Foshan, 528000, Guangdong, China
| | - Biyi Li
- Foshan Hospital of Traditional Chinese Medicine, 6 Qinren Road, Foshan, 528000, Guangdong, China
| | - Yanqing Tan
- Foshan Hospital of Traditional Chinese Medicine, 6 Qinren Road, Foshan, 528000, Guangdong, China
| | - Hongning Zhang
- Foshan Hospital of Traditional Chinese Medicine, 6 Qinren Road, Foshan, 528000, Guangdong, China
| | - Yongzhan Zhu
- Foshan Hospital of Traditional Chinese Medicine, 6 Qinren Road, Foshan, 528000, Guangdong, China.
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Xinqiang Y, Yuanyuan J, Zhipeng Y, Jie K, Xiao T, Yumeng H, Chenxi Z, Shiyu D, Mingpeng Y, Yanlin Z, Sihan C, Hao Y. Systemic administration of dorsomorphin relieves inflammatory nociception in the mouse formalin test. Int Immunopharmacol 2022; 113:109337. [DOI: 10.1016/j.intimp.2022.109337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Revised: 09/29/2022] [Accepted: 10/09/2022] [Indexed: 11/05/2022]
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Xu T, Wu KL, Jie K. Comprehensive meta-analysis of antibiotic-impregnated bone cement versus plain bone cement in primary total knee arthroplasty for preventing periprosthetic joint infection. Chin J Traumatol 2022; 25:325-330. [PMID: 35717367 PMCID: PMC9751532 DOI: 10.1016/j.cjtee.2022.06.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 03/28/2022] [Accepted: 05/21/2022] [Indexed: 02/04/2023] Open
Abstract
PURPOSE Antibiotic-loaded bone cement (ALBC) was usually used to prevent periprosthetic joint infection (PJI) in primary total knee arthroplasty (PTKA), but whether to use ALBC or plain bone cement in PTKA remains unclear. We aimed to compare the occurrence rate of PJI using two different cements, and to investigate the efficacy of different antibiotic types and doses administered in preventing surgical site infection (SSI) with ALBC. METHODS The availability of ALBC for preventing PJI was evaluated by using a systematic review and meta-analysis referring to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Existing articles until December 2021 involving PTKA patients with both ALBC and plain bone cement cohorts were scanned by searching "total knee arthroplasty", "antibiotic-loaded cement", "antibiotic prophylaxis", "antibiotic-impregnated cement" and "antibiotic-laden cement" in the database of PubMed/MEDLINE, Embase, Web of Science and the Cochrane Library. Subgroup analysis included the effectiveness of different antibiotic types and doses in preventing SSI with ALBC. The modified Jadad scale was employed to score the qualities of included articles. RESULTS Eleven quantitative studies were enrolled, including 34,159 knees undergoing PTKA. The meta-analysis results demonstrated that the use of prophylactic ALBC could significantly reduce the prevalence of deep incisional SSI after PTKA, whereas there was no significant reduction in the rate of superficial incisional SSI. Moreover, gentamicin-loaded cement was effective in preventing deep incisional SSI, and the use of high-dose ALBC significantly reduced the rate of deep incisional SSI after PTKA. Besides, no significant adverse reactions and complications were stated during the use of ALBC in PTKA. CONCLUSION The preventive application of ALBC during PTKA could reduce the rates of deep PJI. Furthermore, bone cement containing gentamicin and high-dose ALBC could even better prevent deep infection after PTKA. However, the existing related articles are mostly single-center and retrospective studies, and further high-quality ones are needed for confirmation.
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Affiliation(s)
- Ting Xu
- Foshan Hospital of Traditional Chinese Medicine, Foshan, 528000, Guangdong Province, China
| | - Ke-Liang Wu
- Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, 518000, Guangdong Province, China
| | - Ke Jie
- Foshan Hospital of Traditional Chinese Medicine, Foshan, 528000, Guangdong Province, China,Corresponding author.
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Xing J, Li J, Yan Z, Li Y, Liu X, He L, Xu T, Wang C, Zhao L, Jie K. Diagnostic accuracy of calprotectin in periprosthetic joint infection: a diagnostic meta-analysis. J Orthop Surg Res 2022; 17:11. [PMID: 34991666 PMCID: PMC8739654 DOI: 10.1186/s13018-021-02895-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Accepted: 12/30/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Periprosthetic joint infection (PJI) is considered to be one of the most challenging complications of joint replacement, which remains unpredictable. As a simple and emerging biomarker, calprotectin (CLP) has been considered to be useful in ruling out PJI in recent years. The purpose of this study was to investigate the accuracy and sensitivity of CLP in the diagnosis of PJI. METHODS We searched and screened the publications from PubMed, Web of Science, EMBASE, and Cochrane Library from database establishment to June 2021. Subsequently, Stata version 16.0 software was used to combine the pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), operating characteristic curve, and area under the curve (AUC). Heterogeneity across articles was evaluated by the I2 statistics. Finally, sources of heterogeneity were detected by subgroup analysis based on study design, detection method, sample size, and cutoff values. RESULTS A total of 7 studies were included in our study, comprising 525 patients. The pooled sensitivity, specificity, PLR, and NLR of CLP for PJI diagnosis were 0.94(95% CI 0.87-0.98), 0.93(95% CI 0.87-0.96), 13.65(95% CI 6.89-27.08), and 0.06(95% CI 0.02-0.15), respectively, while the DOR and AUC were 222.33(95% CI 52.52-941.11) and 0.98 (95% CI 0.96-0.99), respectively. CONCLUSION Synovial CLP is a reliable biomarker and can be used as a diagnostic criterion for PJI in the future. However, the uncertainty resulting from the poor study numbers and sample sizes limit our ability to definitely draw conclusions on the basis of our study.
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Affiliation(s)
- Jisi Xing
- Foshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Chinese Medicine, Foshan Hospital of Traditional Chinese Medicine, Foshan, 528000, Guangdong Province, China
| | - Jiahao Li
- The First Clinical Medical School, Guangzhou University of Chinese Medicine, Jichang Road 12#, District Baiyun, Guangzhou, Guangdong, China
| | - Zijian Yan
- The First Clinical Medical School, Guangzhou University of Chinese Medicine, Jichang Road 12#, District Baiyun, Guangzhou, Guangdong, China
| | - Yijin Li
- The First Clinical Medical School, Guangzhou University of Chinese Medicine, Jichang Road 12#, District Baiyun, Guangzhou, Guangdong, China
| | - Xiaofang Liu
- Foshan Hospital of Traditional Chinese Medicine, Foshan, 528000, Guangdong Province, China
| | - Lilei He
- Foshan Hospital of Traditional Chinese Medicine, Foshan, 528000, Guangdong Province, China
| | - Ting Xu
- Foshan Hospital of Traditional Chinese Medicine, Foshan, 528000, Guangdong Province, China
| | - Changbing Wang
- Foshan Hospital of Traditional Chinese Medicine, Foshan, 528000, Guangdong Province, China
| | - Lilian Zhao
- Foshan Hospital of Traditional Chinese Medicine, Foshan, 528000, Guangdong Province, China.
| | - Ke Jie
- Foshan Hospital of Traditional Chinese Medicine, Foshan, 528000, Guangdong Province, China.
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de Rooij EN, Dekker FW, Le Cessie S, Hoorn EJ, de Fijter JW, Hoogeveen EK, Bijlsma J, Boekhout M, Boer W, van der Boog P, Büller H, van Buren M, Charro FD, Doorenbos C, van den Dorpel M, van Es A, Fagel W, Feith G, de Fijter C, Frenken L, Grave W, van Geelen J, Gerlag P, Gorgels J, Huisman R, Jager K, Jie K, Koning-Mulder W, Koolen M, Hovinga TK, Lavrijssen A, Luik A, van der Meulen J, Parlevliet K, Raasveld M, van der Sande F, Schonck M, Schuurmans M, Siegert C, Stegeman C, Stevens P, Thijssen J, Valentijn R, Vastenburg G, Verburgh C, Vincent H, Vos P. Serum Potassium and Mortality Risk in Hemodialysis Patients: A Cohort Study. Kidney Med 2022; 4:100379. [PMID: 35072043 PMCID: PMC8767120 DOI: 10.1016/j.xkme.2021.08.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Rationale & Objective Both hypo- and hyperkalemia can cause fatal cardiac arrhythmias. Although predialysis serum potassium level is a known modifiable risk factor for death in patients receiving hemodialysis, especially for hypokalemia, this risk may be underestimated. Therefore, we investigated the relationship between predialysis serum potassium level and death in incident hemodialysis patients and whether there is an optimum level. Study Design Prospective multicenter cohort study. Setting & Participants 1,117 incident hemodialysis patients (aged >18 years) from the Netherlands Cooperative Study on the Adequacy of Dialysis-2 study were included and followed from their first hemodialysis treatment until death, transplantation, switch to peritoneal dialysis, or a maximum of 10 years. Exposure Predialysis serum potassium levels were obtained every 6 months and divided into 6 categories: ≤4.0 mmol/L, >4.0 mmol/L to ≤4.5 mmol/L, >4.5 mmol/L to ≤5.0 mmol/L, >5.0 mmol/L to ≤5.5 mmol/L (reference), >5.5 mmol/L to ≤6.0 mmol/L, and >6.0 mmol/L. Outcomes 6-month all-cause mortality. Analytical Approach Cox proportional hazards and restricted cubic spline analyses with time-dependent predialysis serum potassium levels were used to calculate the adjusted HRs for death. Results At baseline, the mean age of the patients was 63 years (standard deviation, 14 years), 58% were men, 26% smoked, 24% had diabetes, 32% had cardiovascular disease, the mean serum potassium level was 5.0 mmol/L (standard deviation, 0.8 mmol/L), 7% had a low subjective global assessment score, and the median residual kidney function was 3.5 mL/min/1.73 m2 (IQR, 1.4-4.8 mL/min/1.73 m2). During the 10-year follow-up, 555 (50%) deaths were observed. Multivariable adjusted HRs for death according to the 6 potassium categories were as follows: 1.42 (95% CI, 1.01-1.99), 1.09 (95% CI, 0.82-1.45), 1.21 (95% CI, 0.94-1.56), 1 (reference), 0.95 (95% CI, 0.71-1.28), and 1.32 (95% CI, 0.97-1.81). Limitations Shorter intervals between potassium measurements would have allowed for more precise mortality risk estimations. Conclusions We found a U-shaped relationship between serum potassium level and death in incident hemodialysis patients. A low predialysis serum potassium level was associated with a 1.4-fold stronger risk of death than the optimal level of approximately 5.1 mmol/L. These results may imply the cautious use of potassium-lowering therapy and a potassium-restricted diet in patients receiving hemodialysis.
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Chen J, Jie K, Feng W, Zeng H, Cao H, Deng P, Wu K, Ye P, Li J, Qi X, Zeng J, Zeng Y. Total Calcanectomy and Bilateral Iliac Bone Autograft Reconstruction for the Treatment of Calcaneal Chondroblastoma Involving a Secondary Aneurysmal Bone Cyst: A Case Report and Literature Review. J Foot Ankle Surg 2021; 59:616-624. [PMID: 32354519 DOI: 10.1053/j.jfas.2019.10.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 05/24/2019] [Accepted: 10/01/2019] [Indexed: 02/03/2023]
Abstract
Chondroblastoma is a rare, benign, cartilaginous-derived tumor accounting for ∼1% to 2% of all primary bone tumors and almost 9% of all benign bone tumors. In this case report, we describe a patient with chondroblastoma and a secondary aneurysmal bone cyst, with the adjacent talus being mildly affected. The initial diagnosis was giant cell tumor and was then confirmed after computed tomography-assisted biopsy. We performed a total calcanectomy via bilateral structural iliac bone autografting to relieve pain and reconstruct the loadbearing function because of the presence of extensive lesions. The patient was pain free and expressed satisfaction with postsurgical dorsiflexion and plantarflexion function at the 60-month follow-up visit. Radiographic images showed that the autografted iliac bone was completely healed, with no evidence of local recurrence.
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Affiliation(s)
- Jinlun Chen
- Surgeon, Department of Orthopaedic Surgery, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Ke Jie
- Resident, First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Wenjun Feng
- Surgeon, Department of Orthopaedic Surgery, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Huiliang Zeng
- Surgeon, Department of Orthopaedic Surgery, Foshan Hospital of Traditional Chinese Medicine, Foshan, China
| | - Houran Cao
- Resident, First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Peng Deng
- Surgeon, First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Keliang Wu
- Resident, First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Pengcheng Ye
- Surgeon, Department of Orthopaedic Surgery, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jie Li
- Surgeon, Department of Orthopaedic Surgery, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xinyu Qi
- Resident, First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jianchun Zeng
- Surgeon, Department of Orthopaedic Surgery, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yirong Zeng
- Surgeon and Professor, Department of Orthopaedic Surgery, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.
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Qi X, Jie K, Chen J, Cao H, Koch JA, Li J, Zeng J, Feng W, Zeng Y. Post-THA gait training to improve pelvic obliquity and decrease leg length discrepancy in DDH patients: a retrospective study. J Int Med Res 2021; 48:300060519898034. [PMID: 32223662 PMCID: PMC7133398 DOI: 10.1177/0300060519898034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Objectives To investigate the value of a post-operative gait training program to improve pelvic obliquity (PO) and decrease leg length discrepancy (LLD) for patients with Crowe type I developmental dysplasia of the hip (DDH) undergoing unilateral total hip arthroplasty (THA). Methods The prospective group consisted of 35 patients who underwent one-stage unilateral THA. Pre- and post-training PO and LLD were measured for the radiological assessment and Harris Hip Score (HHS) was used for the functional assessment. Results The HHS improved from 55.54 ± 10.61 pre-operatively to 84.97 ± 7.63 after surgery. The mean post-training PO angle for grade 0, grade 1, and grade 2 were 2.66 ± 1.42, 2.94 ± 1.42, and 5.60 ± 1.90, respectively, compared with pre-training values of 1.42 ± 0.58, 4.17 ± 0.90, and 6.96 ± 0.46. The mean post-training LLD for grade 0, grade 1, and grade 2 were 0.83 ± 0.91, 0.56 ± 0.48, and 0.36 ± 0.30, respectively, compared with pre-training values of 0.70 ± 0.23, 1.25 ± 0.90, and 1.46 ± 1.60. Conclusion Gait training following unilateral THA can improve PO and decrease functional LLD in grade I DDH patients. This method may have moderate success for grade 0 DDH patients and provide limited benefit for grade II patients. Appropriate release of the soft tissues may be required for grade II DDH patients to obtain a better walking gait.
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Affiliation(s)
- Xinyu Qi
- Department of Orthopaedics, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou City, Guangdong Province, China
| | - Ke Jie
- Department of Orthopaedics, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou City, Guangdong Province, China
| | - Jinlun Chen
- Department of Orthopaedics, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou City, Guangdong Province, China
| | - Houran Cao
- Department of Orthopaedics, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou City, Guangdong Province, China
| | - John A Koch
- Arthritis and Arthroplasty Design Laboratory, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jie Li
- Department of Orthopaedics, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou City, Guangdong Province, China
| | - Jianchun Zeng
- Department of Orthopaedics, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou City, Guangdong Province, China
| | - Wenjun Feng
- Department of Orthopaedics, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou City, Guangdong Province, China
| | - Yirong Zeng
- Department of Orthopaedics, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou City, Guangdong Province, China
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Zhang H, Sun X, Xin P, Zhu X, Jie K, Cao H, Feng W, Zeng Y, Lv Y, Chen J, Li J, Zeng J, Zeng Y. Diagnostic accuracy of D-dimer in periprosthetic joint infection: a diagnostic meta-analysis. J Orthop Surg Res 2020; 15:334. [PMID: 32807236 PMCID: PMC7430004 DOI: 10.1186/s13018-020-01853-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Accepted: 07/31/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Periprosthetic joint infection (PJI) is one of the most devastating complications after total joint replacement (TJA). Up to now, the diagnosis of PJI is still in a dilemma. As a novel biomarker, whether D-dimer is valuable in the diagnosis of PJI remains controversial. This meta-analysis attempts to determine the diagnostic accuracy of D-dimer in PJI. METHODS Relevant literature was retrieved from PubMed, Embase, Web of Science, and Cochrane Library (from database establishment to April 2020). Literature quality was evaluated using Revman (version 5.3). The random effect model was used in the Stata version 14.0 software to combine sensitivity, specificity, likelihood ratio (LR), diagnostic odds ratio (DOR), summary receiver operating characteristic (SROC) curve, and area under SROC (AUC) to evaluate the diagnostic value of overall D-dimer for PJI. Meta regression and subgroup analysis were performed according to the threshold, the study design, the sample size, the diagnostic gold standard, the country of study, and the type of sample. RESULTS A total of 9 studies were included in this study, including 1592 patients. The pooled sensitivity and specificity of D-dimer for PJI diagnosis are 0.82 (95% CI, 0.72~0.89) and 0.73 (95% CI, 0.58~0.83), respectively. The pooled positive likelihood ratio (PLR) and negative likelihood ratio (NLR) were 2.99 (95% CI, 1.84~4.88) and 0.25 (95% CI, 0.15~0.41), respectively. The pooled AUC and diagnostic odds ratios were 0.85 (95% CI, 0.82~0.88) and 12.20 (95% CI, 4.98~29.86), respectively. CONCLUSION D-dimer is a promising biomarker for the diagnosis of PJI, which should be used in conjunction with other biomarkers or as an adjunct to other diagnostic methods to enhance diagnostic performance.
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Affiliation(s)
- Haitao Zhang
- The First Clinical Medical School, Guangzhou University of Chinese Medicine, Jichang Road 12#, District Baiyun, Guangzhou, Guangdong, China
| | - Xiaobo Sun
- The First Clinical Medical School, Guangzhou University of Chinese Medicine, Jichang Road 12#, District Baiyun, Guangzhou, Guangdong, China.,Ganzhou Hospital of Traditional Chinese Medicine, Xijin Road 16#, District Zhanggong, Ganzhou, Jiangxi, China
| | - Pengfei Xin
- The First Clinical Medical School, Guangzhou University of Chinese Medicine, Jichang Road 12#, District Baiyun, Guangzhou, Guangdong, China
| | - Xingyang Zhu
- The First Clinical Medical School, Guangzhou University of Chinese Medicine, Jichang Road 12#, District Baiyun, Guangzhou, Guangdong, China
| | - Ke Jie
- The First Clinical Medical School, Guangzhou University of Chinese Medicine, Jichang Road 12#, District Baiyun, Guangzhou, Guangdong, China
| | - Houran Cao
- The First Clinical Medical School, Guangzhou University of Chinese Medicine, Jichang Road 12#, District Baiyun, Guangzhou, Guangdong, China
| | - Wenjun Feng
- Department of Orthopaedics, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Jichang Road 16#, District Baiyun, Guangzhou, 510405, Guangdong, China
| | - Yuqing Zeng
- The First Clinical Medical School, Guangzhou University of Chinese Medicine, Jichang Road 12#, District Baiyun, Guangzhou, Guangdong, China
| | - Yan Lv
- The First Affiliated Hospital of Nanchang University, 17 Yongwai Street, Nanchang, 330006, China
| | - Jinlun Chen
- Department of Orthopaedics, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Jichang Road 16#, District Baiyun, Guangzhou, 510405, Guangdong, China
| | - Jie Li
- Department of Orthopaedics, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Jichang Road 16#, District Baiyun, Guangzhou, 510405, Guangdong, China
| | - Jianchun Zeng
- Department of Orthopaedics, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Jichang Road 16#, District Baiyun, Guangzhou, 510405, Guangdong, China
| | - Yirong Zeng
- Department of Orthopaedics, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Jichang Road 16#, District Baiyun, Guangzhou, 510405, Guangdong, China.
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Korevaar JC, van Manen JG, Boeschoten EW, Dekker FW, Krediet RT, Apperloo A, Barendregt J, Birnie R, Boekhout M, Boer W, Büller H, de Charro F, Doorenbos C, Fagel W, Franssen C, Frenken L, Geerlings W, Gerlag P, Gorgels J, Grave W, Huisman R, Jager K, Jie K, Koning–Mulder W, Koolen M, Kremer Hovinga T, Lavrijssen A, Mulder A, Parlevliet K, Rosman J, Schonk M, Schuurmans M, Stevens P, Tijssen J, Valentijn R, van Bommel E, van Dorp W, van Es A, van Geelen J, van Saase J, Vastenburg G, Verburg C, Verstappen V, Vincent H, Vos P. When to Start Dialysis Treatment: Where Do We Stand? Perit Dial Int 2020. [DOI: 10.1177/089686080502503s17] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
♦ Background Since the publication of opinion-based guidelines regarding the timing of dialysis treatment, there has been a trend toward earlier initiation. ♦ Objective In this review, the existing guidelines and the currently published studies that evaluate them are discussed. ♦ Results These studies could not demonstrate a clear benefit on survival or quality of life for patients who started with relatively higher renal function. ♦ Conclusion Early start of dialysis treatment should not be confused with early referral to the nephrologist. It is concluded that initiation of dialysis should not depend on a predefined magnitude of renal function, but should be tailored to the individual patient.
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Affiliation(s)
- Johanna C. Korevaar
- Department of Clinical Epidemiology and Biostatistics, Academic Medical Center, University of Amsterdam
| | - Jeannette G. van Manen
- Department of Clinical Epidemiology, Leiden University Medical Center, University of Leiden
| | | | - Friedo W. Dekker
- Department of Clinical Epidemiology, Leiden University Medical Center, University of Leiden
| | - Raymond T. Krediet
- Department of Nephrology, Academic Medical Center, University of Amsterdam, The Netherlands
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Feng W, Ye P, Ni S, Deng P, Lu L, Chen J, Zeng J, Qi X, Li J, Jie K, Cao H, Yue Z, Zhang H, Zeng Y. One-stage simultaneous hip-preserving surgeries for the management of bilateral femoral head osteonecrosis: a mean 7.0-year follow-up. J Orthop Surg Res 2019; 14:455. [PMID: 31864402 PMCID: PMC6925467 DOI: 10.1186/s13018-019-1467-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 11/08/2019] [Indexed: 11/10/2022] Open
Abstract
Background A retrospective study was conducted to evaluate and compare the clinical and radiological outcomes of one-stage fibular impaction allografting and vascularized greater trochanter flap autografting for the treatment of bilateral osteonecrosis of the femoral head (ONFH). Methods Patients who underwent one-stage aforementioned hip-preserving surgeries due to bilateral ONFH were retrospectively reviewed from January 2008 to December 2013. Sixty-nine patients (138 hips) with a mean age of 31.5 years and mean follow-up of 7.0 years were included. Hips that underwent fibular impaction allografting and vascularized greater trochanter flap autografting were assigned as group A and group B, respectively. Harris Hip Score (HHS) and Visual Analogue Scale (VAS) were used for clinical evaluation, and a series of X-ray images were used for radiological assessment. For inter-group analysis, the paired t test was used for continuous data, and the Wilcoxon rank sum test was used for non-parametric data, while the Mann-Whitney U test was used for intra-group analysis. Results The HHS and VAS in both groups A and B had a substantial advancement when compared with the preoperative level (p < 0.01). Fibular impaction allografting can achieve more pain relief (p < 0.01), though no clinical difference was found in terms of minimal clinically important difference (MCID < 10 points). Group A showed better radiological results than group B (p = 0.04). It was discovered that the appropriate indication for each procedure was patients with Association for Research on Osseous Circulation (ARCO) stages II and III, respectively. Conclusion One-stage hip-preserving surgeries for the management of bilateral ONFH could obtain good medium and long-term outcomes. It was recommended that fibular impaction allografting is more suitable for patients in ARCO stage II, while for patients in ARCO stage III, vascularized greater trochanter flap autografting is a better preference. Trial registration Retrospectively registered.
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Affiliation(s)
- Wenjun Feng
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Jichang Road 16#, District Baiyun, Guangzhou, Guangdong, China.
| | - Pengcheng Ye
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Jichang Road 16#, District Baiyun, Guangzhou, Guangdong, China
| | - Shihao Ni
- Guangzhou University of Chinese Medicine, Jichang Road 12#, District Baiyun, Guangzhou, Guangdong, China
| | - Peng Deng
- Guangzhou University of Chinese Medicine, Jichang Road 12#, District Baiyun, Guangzhou, Guangdong, China
| | - Lu Lu
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Linnan Medical Research Center of Guangzhou University of Chinese Medicine, Jichang Road 16#, District Baiyun, Guangzhou, Guangdong, China
| | - Jinlun Chen
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Jichang Road 16#, District Baiyun, Guangzhou, Guangdong, China
| | - Jianchun Zeng
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Jichang Road 16#, District Baiyun, Guangzhou, Guangdong, China
| | - Xinyu Qi
- Guangzhou University of Chinese Medicine, Jichang Road 12#, District Baiyun, Guangzhou, Guangdong, China
| | - Jie Li
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Jichang Road 16#, District Baiyun, Guangzhou, Guangdong, China
| | - Ke Jie
- Guangzhou University of Chinese Medicine, Jichang Road 16#, District Baiyun, Guangzhou, Guangdong, China
| | - Houran Cao
- Guangzhou University of Chinese Medicine, Jichang Road 12#, District Baiyun, Guangzhou, Guangdong, China
| | - Zhijun Yue
- Guangzhou University of Chinese Medicine, Jichang Road 12#, District Baiyun, Guangzhou, Guangdong, China
| | - Haitao Zhang
- Guangzhou University of Chinese Medicine, Jichang Road 12#, District Baiyun, Guangzhou, Guangdong, China
| | - Yirong Zeng
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Jichang Road 16#, District Baiyun, Guangzhou, Guangdong, China.
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Jie K, Deng P, Cao H, Feng W, Chen J, Zeng Y. Prosthesis design of animal models of periprosthetic joint infection following total knee arthroplasty: A systematic review. PLoS One 2019; 14:e0223402. [PMID: 31581252 PMCID: PMC6776332 DOI: 10.1371/journal.pone.0223402] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 09/21/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The number of periprosthetic joint infections (PJI) after total knee arthroplasty (TKA) is increasing annually. Animal models have been used to clarify their clinical characteristics and the infection mechanism of pathogenic bacteria, However, since the prosthesis design of animal models is not uniform, it is difficult to simulate the environment of clinical PJI. OBJECTIVES To retrospect the progress on the prosthesis design of animal models of PJI after TKA and to summarize the criteria for evaluating a clinically representative model of PJI. METHODS This systematic review was reported on the basis of Systematic Reviews and Meta-Analyzes (PRISMA). Pubmed, EMbase, Cochrane Library, Web of Science, Wanfang Data and China National Knowledge Infrastructure were researched for animal models of PJI after TKA from database establishment to April 2019 according to Chinese and English retrieval words, including "periprosthetic joint infections and total knee arthroplasty," "periprosthetic joint infections and model," "periprosthetic joint infections and biofilm," and "total knee arthroplasty and model." RESULTS A total of 12 quantitative studies were enrolled in our study finally: 8 representative studies described prosthesis designs used in PJI animal models, 4 studies described prosthesis designs in non-infected animal models which were suitable for infection models. The major problems need to be dealed with were prosthesis, installation location, material, the function of separating the articular and medullary cavity, fixation manner, and the procedure of preserving the posterior cruciate ligament. CONCLUSION A highly representative design of the animal prosthesis of PJI should meet the following criteria: the surface of the prosthesis is smooth with the formation of biofilm, composed of titanium-6Al-4V or cobalt-chromium-molybdenum alloy; prosthesis can bear weight and is highly stable; and it can connect the joint cavity and medullary cavity simultaneously. To reach a more reliable conclusion, further experiments and improvements are required.
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Affiliation(s)
- Ke Jie
- The First Clinical Medical College, Guangzhou University of Chinese Medicine, Baiyun District, Guangzhou, Guangdong Province, China
| | - Peng Deng
- The First Clinical Medical College, Guangzhou University of Chinese Medicine, Baiyun District, Guangzhou, Guangdong Province, China
- The Third Department of Orthopedics, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Baiyun District, Guangzhou, Guangdong Province, China
| | - Houran Cao
- The First Clinical Medical College, Guangzhou University of Chinese Medicine, Baiyun District, Guangzhou, Guangdong Province, China
| | - Wenjun Feng
- The Third Department of Orthopedics, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Baiyun District, Guangzhou, Guangdong Province, China
| | - Jinlun Chen
- The Third Department of Orthopedics, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Baiyun District, Guangzhou, Guangdong Province, China
| | - Yirong Zeng
- The Third Department of Orthopedics, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Baiyun District, Guangzhou, Guangdong Province, China
- * E-mail:
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Feng W, Chen J, Wu K, Lu L, Deng P, Ye P, Cao H, Li J, Zeng J, Jie K, Qi X, Zeng Y. A comparative study of cortico-cancellous iliac bone graft with or without the combination of vascularized greater trochanter flap for the management of femoral head osteonecrosis: a minimum 6 years follow-up. BMC Musculoskelet Disord 2019; 20:298. [PMID: 31228939 PMCID: PMC6589174 DOI: 10.1186/s12891-019-2613-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Accepted: 05/03/2019] [Indexed: 01/30/2023] Open
Abstract
Background To compare the mid-long-term clinical and radiological outcomes between a combination of cortico-cancellous iliac bone graft with vascularized greater trochanter flap (Group A) and isolate iliac bone graft (Group B) in the treatment of Osteonecrosis of the Femoral Head (ONFH). Methods From January 2006 to December 2012, 123 patients (135 hips) who underwent abovementioned hip-preserving surgeries were included for analysis. Clinical outcomes were assessed based on Harris Hip Score (HHS) System and The Western Ontario and McMaster University Index (WOMAC) scores between the preoperative and the last follow-up. A series of postoperative X-rays were compared to preoperative images for radiological evaluation. Results The HHS in Group A and B were enhanced from 50.57 ± 3.39 to 87.60 ± 4.15 and from 50.24 ± 3.30 to 85.18 ± 6.45, respectively, which both showed significance between preoperative and postoperative latest follow-up (p < 0.001). Group A revealed better improvement in terms of HHS (p = 0.017). The WOMAC total, postoperative stiffness, difficulty subscale scores in Group A showed better outcomes when compared to Group B (p < 0.01), while pain improvement between these two groups revealed no significance (p = 0.402). Besides, Group A suggested better necrotic region repair (p = 0.020), but no femoral head collapse difference in terms of Association Research Circulation Osseous classification change was found (p > 0.05). Conclusions A combination of cortico-cancellous iliac bone graft and concurrent vascularized greater trochanter flap with the lateral femoral circumflex transverse branch has been proved can obtain better functional and radiological results than isolate iliac bone grafting, which is attributed to blood reconstruction of the femoral head.
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Affiliation(s)
- Wenjun Feng
- Guangzhou University of Chinese Medicine, Jichang Road 16#, District Baiyun, Guangzhou, Guangdong, China.
| | - Jinlun Chen
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Jichang Road 16#, District Baiyun, Guangzhou, Guangdong, China
| | - Keliang Wu
- Guangzhou University of Chinese Medicine, Jichang Road 12#, District Baiyun, Guangzhou, Guangdong, China
| | - Lu Lu
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Linnan Medical Research Center of Guangzhou University of Chinese Medicine, Jichang Road 16#, District Baiyun, Guangzhou, Guangdong, China
| | - Peng Deng
- Guangzhou University of Chinese Medicine, Jichang Road 12#, District Baiyun, Guangzhou, Guangdong, China
| | - Pengcheng Ye
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Jichang Road 16#, District Baiyun, Guangzhou, Guangdong, China
| | - Houran Cao
- Guangzhou University of Chinese Medicine, Jichang Road 12#, District Baiyun, Guangzhou, Guangdong, China
| | - Jie Li
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Jichang Road 16#, District Baiyun, Guangzhou, Guangdong, China
| | - Jianchun Zeng
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Jichang Road 16#, District Baiyun, Guangzhou, Guangdong, China
| | - Ke Jie
- Guangzhou University of Chinese Medicine, Jichang Road 16#, District Baiyun, Guangzhou, Guangdong, China
| | - Xinyu Qi
- Guangzhou University of Chinese Medicine, Jichang Road 12#, District Baiyun, Guangzhou, Guangdong, China
| | - Yirong Zeng
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Jichang Road 16#, District Baiyun, Guangzhou, Guangdong, China.
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Zhang X, Jie K, Huang Y, Li Z, Tang W. Retracted: Effects of Acupuncture on 1-Chloro-2,4-Dinitrochlorobenzene–Induced Allergic Contact Dermatitis in Mice. Med Acupunct 2016. [DOI: 10.1089/acu.2016.1172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Xuwen Zhang
- Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Ke Jie
- Guangzhou University of Chinese Medicine, Guangzhou, China
| | | | - Zengnian Li
- Guangzhou University of Chinese Medicine, Guangzhou, China
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Jie K, Jie L, Ming-Hong Z, Lei Z, Bu-Xing H, Hai-Ke Y. Effect of Ethanol on the Tautomerism of Ethyl Acetoacetate in Supercritical CO<sub>2</sub>. ACTA PHYS-CHIM SIN 1997. [DOI: 10.3866/pku.whxb19970412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Ming-Hong Z, Jie K, Bu-Xing H, Hai-Ke Y. Densities of CO 2-Ethanol,CO 2-Acetone,CO 2-Heptane Binary Mixtures and Partial Molar Volumes of the Solutes. ACTA PHYS-CHIM SIN 1996. [DOI: 10.3866/pku.whxb19960909] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Jie K, Shun-Zi J, Bu-Xing H, Hai-Ke Y, De-Yan S. FTIR Study on the Interactions between Benzoic Acid and Ethanol,Benzoic Acid and Dimethyl Sulfoxide in Supercritical CO<sub>2</sub>. ACTA PHYS-CHIM SIN 1996. [DOI: 10.3866/pku.whxb19961106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Abstract
The knowledge on alpha-adrenoceptors has expanded enormously in the last decade, mostly as a result of in vitro and in vivo animal experiments. In the face of considerable species differences we have tested several of the newly developed concepts on alpha-adrenoceptors in the circulation of the human forearm. In this model we were able to show the presence of postsynaptic alpha 1- and alpha 2-adrenoceptors, both contributing to resting vascular tone. Although adrenaline and noradrenaline were shown to have affinity for each alpha-adrenoceptor subtype, noradrenaline seems to be the natural agonist for both receptors. Evidence is presented for an intrasynaptic location of the alpha 1-adrenoceptor and an extrasynaptic location of the alpha 2-adrenoceptor and also for a functional presynaptic alpha 2-adrenoceptor in the human forearm circulation. Selective hyperresponsiveness to alpha 1- or alpha 2-adrenoceptor stimulation in hypertensive patients could not be established. Calcium entry blockers were shown to attenuate the vasoconstriction induced by selective alpha 2-adrenoceptor stimulation but not by selective alpha 1-adrenoceptor stimulation. These data support the physiological and pharmacological relevance of the new concepts on alpha-adrenoceptors for the situation in man.
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Affiliation(s)
- P van Brummelen
- Department of Nephrology, University Hospital, Leiden, The Netherlands
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Jie K, Van Brummelen P, Vermey P, Timmermans PB, Van Zwieten PA. Postsynaptic alpha 1- and alpha 2-adrenoceptors in human blood vessels: interactions with exogenous and endogenous catecholamines. Eur J Clin Invest 1987; 17:174-81. [PMID: 3034621 DOI: 10.1111/j.1365-2362.1987.tb02397.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The relative efficacy of epinephrine and norepinephrine on vascular alpha 1- and alpha 2-adrenoceptors and also the difference in vasoconstriction induced by exogenous norepinephrine as opposed to neuronally released norepinephrine were studied in the forearm of healthy volunteers. Intra-arterial cumulative dose infusions of epinephrine and norepinephrine (0.6, 1.6 and 4.0 ng kg-1 min-1) were given in the presence of saline, the selective alpha 1-antagonist doxazosin (0.1 microgram kg min-1) the selective alpha 2-antagonist yohimbine (1.0 microgram kg min-1) and the combination of both antagonists. beta-Adrenoceptor-mediated effects were prevented by a concomitant i.a. infusion of propranolol (1.0 microgram kg-1 min-1). Forearm blood flow (FBF) was measured before each infusion and at the end of each dose step. Neuronal norepinephrine was released by i.a. infusion of tyramine in three cumulative doses (0.25, 0.50 and 1.25 micrograms kg-1 min-1) and by lower body negative pressure (LBNP, -40 mmHg for 5 min). Changes in FBF were measured without and with concomitant i.a. infusions of the aforementioned doses of doxazosin and yohimbine. In the LBNP experiment the opposite arm was used as a control. Forearm blood flow was measured by plethysmography. Epinephrine and norepinephrine induced an equal and dose-dependent vasoconstriction, which was significantly inhibited by doxazosin as well as yohimbine and to a greater extent by the combination of the antagonists. No differences were found between epinephrine and norepinephrine in this respect.(ABSTRACT TRUNCATED AT 250 WORDS)
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Jie K, van Brummelen P, Vermey P, Timmermans PB, van Zwieten PA. Modulation of noradrenaline release by peripheral presynaptic alpha 2-adrenoceptors in humans. J Cardiovasc Pharmacol 1987; 9:407-13. [PMID: 2438503 DOI: 10.1097/00005344-198704000-00005] [Citation(s) in RCA: 27] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The existence of a functional presynaptic alpha 2-adrenoceptor that modulates noradrenaline release was studied in 15 volunteers. Noradrenaline spillover was measured in the forearm under basal conditions, during single intraarterial infusions of the alpha-adrenoceptor antagonists yohimbine (alpha 2, 1.0 micrograms/kg/min) and doxazosin (alpha 1, 0.1 microgram/kg/min), and during intraarterial infusion of tyramine (1.25 microgram/kg/min) alone and in combination with either and both alpha-adrenoceptor antagonists. Forearm blood flow (FBF) was measured by plethysmography. Noradrenaline spillover was calculated as the product of FBF and the difference in arterial and venous plasma noradrenaline. The various infusions did not induce systemic hemodynamic effects. Tyramine induced a dose-dependent decrease in FBF (p less than 0.001) which was reduced by yohimbine (p less than 0.01), as well as by doxazosin (p less than 0.01), and abolished by the combination of both alpha-adrenoceptor antagonists (p less than 0.001). During basal conditions noradrenaline spillover was virtually zero, and this was not changed by yohimbine or doxazosin. Local infusion of tyramine increased noradrenaline spillover (p less than 0.05). This tyramine-induced noradrenaline spillover was further increased by yohimbine (p less than 0.01) and by the combination of yohimbine and doxazosin (p less than 0.001). The single infusion of doxazosin only enhanced the tyramine-induced noradrenaline spillover significantly when it was preceded by yohimbine. The present investigation supports the concept of a presynaptic alpha 2-adrenoceptor modulating noradrenaline release from sympathetic nerve endings via a negative feedback mechanism in humans. Stimulation of noradrenaline release might help to reveal this mechanism.
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Jie K, van Brummelen P, Vermey P, Timmermans PB, van Zwieten PA. Influence of calcium entry blockade on alpha 1- and alpha 2-adrenoceptor mediated vasoconstriction in the forearm of hypertensive patients. Eur J Clin Pharmacol 1987; 32:115-20. [PMID: 3034623 DOI: 10.1007/bf00542182] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The influence of treatment with the calcium entry blockers PY 108-068 (PY) and PN 200-110 (PN) on alpha 1- and alpha 2-adrenoceptor mediated vasoconstriction has been investigated in the forearms of hypertensive patients. Changes in forearm vascular resistance (FVR) in response to the intra-arterial infusion of drugs were determined at the end of a placebo period and after 2-4 weeks of treatment with PY or PN. The drugs used were the selective agonists methoxamine (alpha 1) and B-HT 933 (alpha 2). During placebo, basal FVR was dose-dependently increased by methoxamine and B-HT 933. Basal blood pressure was lowered during PN but not during PY. Treatment with the calcium entry blockers did not influence the effect of methoxamine, but the vasoconstriction induced by B-HT 933 was attenuated by both of the calcium entry blockers. These results confirm the findings in animal studies that calcium entry blockers preferentially inhibit the alpha 2-adrenoceptor mediated vasoconstriction induced by selective agonists.
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Abstract
The evidence for the presence of postjunctional alpha 1- and alpha 2-adrenoceptor subtypes in human blood vessels is reviewed. Experiments in healthy subjects are described that show that alpha 1- as well as alpha 2-adrenoceptor mediated vasoconstriction contribute to vascular smooth muscle tone and that adrenaline and noradrenaline have similar affinities for each subtype. In addition, evidence is presented for a preferential intrajunctional location of alpha 1-adrenoceptors and a preferential extrajunctional location of alpha 2-adrenoceptors in human blood vessels. It is concluded that at present postjunctional alpha-adrenoceptors in human blood vessels can be classified as alpha 1 and alpha 2. Despite the fact that both subtypes mediate vasoconstriction, these receptors are likely to subserve different physiological functions.
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Jie K, van Brummelen P, Vermey P, Timmermans PB, van Zwieten PA. Differences between exogenous and endogenous noradrenaline in the effects on vascular post-synaptic alpha 1- and alpha 2-adrenoceptors in man. J Hypertens Suppl 1985; 3:S145-7. [PMID: 2856814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Effects of exogenous and endogenous noradrenaline, released by tyramine and lower body negative pressure (LBNP), on vascular post-synaptic alpha 1- and alpha 2-adrenoceptors have been compared in healthy volunteers. Intra-arterial (i.a.) infusions of noradrenaline and tyramine into the forearm were given in the presence of saline, of yohimbine and of doxazosin, and changes in forearm blood flow (FBF) were measured. Lower body negative pressure of -40 mmHg was applied without and with a continuous i.a. infusion of yohimbine and of doxazosin, and changes in FBF in both forearms were compared. Forearm blood flow was measured by venous occlusion plethysmography. Noradrenaline and tyramine reduced FBF dose-dependently and to the same extent. Both these vasoconstrictions were significantly reduced by yohimbine (P < 0.001 for both) as well as by doxazosin (P < 0.05 for noradrenaline and P < 0.001 for tyramine). The tyramine-induced vasoconstriction was more effectively reduced by doxazosin, whereas yohimbine reduced the noradrenaline-induced vasoconstriction more effectively. Lower body negative pressure reduced FBF in both forearms to the same extent. Doxazosin effectively inhibited the LBNP induced decrease in FBF (P < 0.05) whereas yohimbine had no effect (P > 0.05). These results are in accordance with a predominant intrasynaptic location of post-synaptic alpha 1-adrenoceptors and a predominant extrasynaptic location of post-synaptic alpha 2-adrenoceptors in human blood vessels.
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MESH Headings
- Adult
- Blood Pressure/drug effects
- Blood Pressure/physiology
- Humans
- Lower Body Negative Pressure
- Male
- Muscle, Smooth, Vascular/drug effects
- Muscle, Smooth, Vascular/innervation
- Muscle, Smooth, Vascular/physiology
- Norepinephrine/administration & dosage
- Norepinephrine/pharmacology
- Norepinephrine/physiology
- Receptors, Adrenergic, alpha/drug effects
- Receptors, Adrenergic, alpha/physiology
- Synapses/drug effects
- Synapses/metabolism
- Tyramine/pharmacology
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Affiliation(s)
- K Jie
- Department of Nephrology, University Hospital Leiden, The Netherlands
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Jie K, van Brummelen P, Vermey P, Timmermans PB, van Zwieten PA. Alpha 1- and alpha 2-adrenoceptor mediated vasoconstriction in the forearm: differences between normotensive and hypertensive subjects. J Hypertens Suppl 1985; 3:S89-91. [PMID: 2908822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Alpha 1- and alpha 2-adrenoceptor mediated vasoconstriction were compared between 13 patients with essential hypertension and 13 normotensive controls, matched for age and sex. For this purpose changes in forearm blood flow induced by infusion of the selective alpha 1-adrenoceptor agonist methoxamine, the selective alpha 2-adrenoceptor agonist B-HT 933, the catecholamines adrenaline and noradrenaline and the alpha 2-adrenoceptor antagonist yohimbine were measured in both study groups. The catecholamines were infused together with propranolol to avoid beta-adrenergic effects. Forearm blood flow was measured by plethysmography. All agonists produced a dose-dependent vasoconstriction which was more pronounced in the hypertensive subjects but no preference was found for either the alpha 1- or alpha 2-adrenoceptor mediated vasoconstriction. Yohimbine induced a greater vasodilatation in the normotensive subjects. The greater vasoconstriction in the hypertensive patients could be explained by structural vascular changes. No evidence was found for an important role of alpha 2-adrenoceptor mediated vasoconstriction in essential hypertension.
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Affiliation(s)
- K Jie
- Department of Nephrology, University Hospital, Leiden, The Netherlands
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Jie K, van Brummelen P, Timmermans PB, Thoolen MJ, van Zwieten PA. Effects of PN 200-110, a new calcium antagonist, on alpha 1- and alpha 2-adrenoceptor mediated vasoconstriction elicited by selective alpha-adrenoceptor agonists and catecholamines in the pithed rat. Arch Int Pharmacodyn Ther 1985; 278:72-86. [PMID: 2869738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The inhibitory action of PN 200-110, a novel calcium antagonist, on alpha 1- and alpha 2-adrenoceptor mediated pressor effects elicited by selective alpha-adrenoceptor agonists and catecholamines was studied in pithed rats. The pressor effects of the selective alpha 1-adrenoceptor agonist cirazoline were only slightly influenced by PN 200-110 (0.1 mg/kg). On the other hand, PN 200-110 efficiently inhibited the hypertensive effects of the selective alpha 2-adrenoceptor agonist B-HT 920 in a dose-dependent way, thereby reducing the maximal response considerably (pD2' = 7.30). The alpha 1-adrenoceptor mediated pressor responses of adrenaline and noradrenaline, obtained after pretreatment with propranolol and the selective alpha 2-adrenoceptor antagonist yohimbine, were slightly inhibited by PN 200-110, without influencing maximal responses. PN 200-110 inhibited the alpha 1-adrenergic pressor effects of noradrenaline better than those of adrenaline. The alpha 2-adrenoceptor mediated pressor effects of the cathecholamines obtained after pretreatment with propranolol and the selective alpha 1-adrenoceptor antagonist prazosin, were highly susceptible to blockade by PN 200-110 except for the high doses (300 micrograms/kg) of adrenaline. The present study establishes the pronounced calcium entry inhibitory potency of PN 200-110 and confirms and extends previous observations that blockade of calcium entry preferably impairs alpha 2-adrenoceptor mediated vasoconstriction in vivo, when compared to that elicited by alpha 1-adrenoceptor stimulation.
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Jie K, van Brummelen P, Vermey P, Timmermans PB, van Zwieten PA. Effects of exogenous adrenaline and noradrenaline on vascular postsynaptic alpha 1- and alpha 2-adrenoceptors in man. J Hypertens Suppl 1984; 2:S119-21. [PMID: 6100733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
The effects of adrenaline and noradrenaline on vascular postsynaptic alpha 1- and alpha 2-adrenoceptors were investigated in six healthy volunteers. The catecholamines were infused intra-arterially, in three cumulative doses, together with a continuous infusion of saline, doxazosin (alpha 1-selective antagonist), yohimbine (alpha 2-selective antagonist) or the combination of the two antagonists, and changes in forearm blood flow were measured by plethysmography. beta-adrenoceptor mediated effects of the catecholamines were prevented by concomitant intra-arterial infusion of propranolol. Adrenaline and noradrenaline reduced forearm blood flow dose-dependently and to the same extent. The vasoconstrictive effect of adrenaline and of noradrenaline was significantly reduced by doxazosin and by yohimbine, and, to a greater extent, by the combination of doxazosin and yohimbine. The magnitude of these reductions were approximately the same for adrenaline and noradrenaline. No changes in heart rate or blood pressure were observed during the infusions. It is concluded that exogenous adrenaline and noradrenaline produce vasoconstriction in the vasculature of the human forearm by stimulation of both postsynaptic alpha 1- and alpha 2-adrenoceptors.
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Abstract
We studied postsynaptic alpha-adrenoceptors in human blood vessels by measuring the influence on forearm blood flow induced by intra-arterial infusions of selective alpha 1- and alpha 2-adrenoceptor agonists (methoxamine, B-HT 933, clonidine and guanfacine) and antagonists (doxazosin and yohimbine). The studies were done in healthy volunteers, and forearm blood flow was measured by plethysmography. All agonists produced a significant and dose-dependent vasoconstriction. The effect of B-HT 933 was completely abolished by the concomitant infusion of yohimbine, whereas it was hardly influenced by doxazosin. The effect of methoxamine was prevented by doxazosin and little influenced by yohimbine. The vasoconstriction by clonidine and guanfacine was partially prevented by both doxazosin and yohimbine. The single intra-arterial infusion of yohimbine, as well as doxazosin, resulted in vasodilation. These findings provide strong evidence for the existence of postsynaptic alpha 1- as well as alpha 2-adrenoceptors, both mediating vasoconstriction and contributing to basal vascular tone. The (patho-)physiological significance of this subdivision of alpha-adrenoceptors remains to be elucidated.
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Bijvoet OL, Frijlink WB, Jie K, van der Linden H, Meijer CJ, Mulder H, van Paassen HC, Reitsma PH, te Velde J, de Vries E, van der Wey JP. APD in Paget's disease of bone. Role of the mononuclear phagocyte system? Arthritis Rheum 1980; 23:1193-204. [PMID: 6448605 DOI: 10.1002/art.1780231018] [Citation(s) in RCA: 108] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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