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Schuh A, Unterpaintner I, Sesselmann S, Feyrer M, Koehl P. CUBITAL TUNNEL SYNDROME DUE TO AN INTRANEURAL GANGLION CYST OF THE ULNAR NERVE. Georgian Med News 2023:50-52. [PMID: 38096515] [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: 12/18/2023]
Abstract
Cubital tunnel syndrome is the second most common neuropathy of the upper extremity. Cubital tunnel syndrome caused by intraneural ganglion cysts is rare in clinical practice. We present the case of a 71-year-old male patient with a 4-month history of cubital tunnel syndrome of the left elbow due to an intraneural ganglion cyst. After revision of the ulnar nerve and resection of the intraneural cyst nearly complete recovery was achieved within a 5 month follow-up but some sensory deficits of the fifth fingertip. We recommend preoperative ultrasound examination of the cubital tunnel even in cases with clear diagnosis. Ganglion cyst as a cause of cubital tunnel is rare but needs to be diagnosed and treated as soon as possible to prevent irreversible complications.
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Affiliation(s)
- A Schuh
- 1Hospital of Trauma Surgery, Department of Musculoskeletal Research, Marktredwitz Hospital, Germany
| | | | - S Sesselmann
- 3Technical University of Applied Sciences Würzburg-Schweinfurt, Germany
| | - M Feyrer
- 4Department of Industrial Engineering and Health, Institute of Medical Engineering, Technical University of Applied Sciences Amberg-Weiden, Germany
| | - Ph Koehl
- 2Hospital of Trauma Surgery, Marktredwitz Hospital, Germany
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Feyrer M, Schuh A, Rupprecht H, Hennig H, Sesselmann S, Koehl P. TRAUMATIC PULMONARY HERNIATION: A RARE CHEST TRAUMA MANIFESTATION. Georgian Med News 2023:104-106. [PMID: 38096525] [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: 12/18/2023]
Abstract
Traumatic pulmonary hernia is an uncommon occurrence resulting from chest trauma, typically covered by the skin. Chest trauma may arise from penetrating or blunt mechanisms, with blunt trauma being more frequently observed. When lung herniation transpires, various symptoms such as chest pain, dyspnea, subcutaneous emphysema, bone crepitation, and hemoptysis (in cases of lung parenchymal damage) may manifest. We present the case of a 66-year-old woman suffering from chest pain and dyspnea after blunt chest trauma due to a fall induced by delirium following alcohol abuse.
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Affiliation(s)
- M Feyrer
- 1Department of Industrial Engineering and Health, Institute of Medical Engineering, Technical University of Applied Sciences Amberg-Weiden, Weiden, Germany
| | - A Schuh
- 2Hospital of Trauma Surgery, Department of Musculoskeletal Research, Marktredwitz Hospital, Germany
| | - H Rupprecht
- 3Department of Thoracic Surgery, Neumarkt Hospital, Germany
| | - H Hennig
- 4Emergency Department, Neumarkt Hospital, Germany
| | - S Sesselmann
- 5Technical University of Applied Sciences Würzburg-Schweinfurt, Würzburg, Germany
| | - Ph Koehl
- 6Hospital of Trauma Surgery, Marktredwitz Hospital, Germany
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Feyrer M, Sesselmann S, Koehl P, Schuh A. AN INTRATENDINOUS GANGLION CYST OF THE PATELLAR TENDON: A RARE CAUSE OF ANTERIOR KNEE PAIN. Georgian Med News 2023:204-205. [PMID: 38096541] [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: 12/18/2023]
Abstract
Ganglion cysts in the knee region can manifest as anterior knee pain. Unlike synovial cysts, these lesions lack synovial epithelial lining and occur secondary to mucoid degeneration of connective tissue because, often in response to chronic irritation and repetitive traumas. However, an intratendinous location is a rare finding. In the knee region, infrapatellar fat pad, the alar folds, and the anterior cruciate ligament are recognized to degenerate into ganglion. There are few case reports describing an involvement of the patellar tendon. We present the clinical case of a 72 years old male patient suffering from anterior knee pain attributed to an intratendinous ganglion cyst of the patellar tendon, obviously after a single traumatic event. After aspiration of the ganglion cyst the patient reported no complaints, and there has been no recurrence during the latest follow-up examination.
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Affiliation(s)
- M Feyrer
- 1Department of Industrial Engineering and Health, Institute of Medical Engineering, Technical University of Applied Sciences Amberg-Weiden, Weiden, Germany
| | - S Sesselmann
- 2Technical University of Applied Sciences Würzburg-Schweinfurt, Würzburg, Germany
| | - Ph Koehl
- 3Hospital of Trauma Surgery, Department of Orthopedics, Marktredwitz Hospital, Germany
| | - A Schuh
- 4Hospital of Trauma Surgery, Department of Musculoskeletal Research, Marktredwitz Hospital, Germany
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Doul M, Koehl P, Betsch M, Sesselmann S, Schuh A. RETURN TO SPORT AFTER SURGICAL TREATED TIBIAL PLATEAU FRACTURES. Georgian Med News 2023:64-68. [PMID: 37042591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Abstract
Tibial plateau fractures (TPF) comprise 1% of all fractures, despite their limited frequency, due to their intraarticular nature they commonly result in significant functional morbidity. Generally, younger, and middle-aged men (64%) tend to have fractures as a result of high-energy trauma, such as high-speed motor vehicle accidents or falls from a considerable height, while older women have low-energy fractures (35%). While there is growing evidence on the clinical and radiological outcomes of surgical techniques, there remains limited evidence on return to sport following TPF. Aim of this retrospective study is to determine the sporting abilities of patients after operative treatment of TPF. 47 Patients (20 women, 27 men) who underwent surgical treatment for a TPF were surveyed by a questionnaire to determine their sporting activity were followed- up a mean of 47.6 months (Min: 12, Max: 115). All the patients fractures were systematically assessed using AO- Classification. The Lysholm-Gillquist scores, IKDC Score, Injury - Psychological Readiness to Return to Sport (I-PRRS) scales and ACL-Return to Sport Injury Scale (ACL-RSI) were used to assess clinical outcomes. All fractures united, and no revision surgeries were required. There were no intraoperative complications. Mean postoperative IKDC score was 75 (Min:13, Max: 100), mean postoperative Lysholm score was 82 (Min: 5, Max: 100), mean ACL-Return to Sport Injury Scale (ACL-RSI) was 66 (Min: 0, Max: 100), Injury-Psychological Readiness to Return to Sport Scale (I-PRRS-Scale) was 39 (Min: 0, Max: 80). 31/47 patients were able to return to their former -sports- activity level, 8/47 did not achieve their former sports activity level before injury, 2/47 cases changed their kind of sport and 6/47 stopped sporting activities. Tibial plateau fractures -a severe injury- have a great effect on patients in terms of quality and quantity of sporting activity. Nevertheless, most of our surgical treated patients were satisfied with the outcome with good values in the Lysholm- score, I-PRRS- Scale, IKDC score and ACL-Return to Sport Injury Scale.
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Affiliation(s)
- M Doul
- 1Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany; 2Hospital of Trauma Surgery, Marktredwitz Hospital, Germany
| | - Ph Koehl
- 2Hospital of Trauma Surgery, Marktredwitz Hospital, Germany
| | - M Betsch
- 3University Hospital Erlangen, Department of Orthopaedics and Trauma Surgery, Friedrich-Alexander-University Erlangen-Nuremberg, Germany
| | - S Sesselmann
- 4Institute for Medical Engineering, OTH Technical University of Applied Sciences, Amberg-Weiden, Weiden, Germany
| | - A Schuh
- 5Hospital of Trauma Surgery, Department of Musculoskeletal Research, Marktredwitz Hospital, Germany
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Semmelmann T, Schuh A, Rottmann H, Schröder R, Fleischmann C, Sesselmann S. HOW TO AVOID FRACTURE OF THE LOCKING SCREW IN MODULAR REVISION ARTHROPLASTY OF THE HIP USING THE MRP TITAN REVISION SYSTEM. Georgian Med News 2023:32-35. [PMID: 37042585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Abstract
The use of modular femoral stems in primary and revision arthroplasty of the hip has become popular within the last decade. On the other hand, modularity creates new potential problems like fretting, crevice and galvanic corrosion, component loosening, dissociation, and fracture of modular prostheses. Recently a problem of fracture of a locking screw in revision arthroplasty of the hip using the MRP Titan Stem (Peter Brehm GmbH, Weisendorf, 91085 Germany) appeared. The aim of this study is to evaluate the meaning of surface contamination in respect to fracture mechanism. The titanium nitrid coated locking screw M6 of the MRP Titan system was in vitro tested in several series. After experimental contamination (series 1-4) morse taper junction was fixed by the locking screw with a torque wrench: Series 1: The influence of contamination with dried blood was examined while screw M6 was put into pig's blood. Series 2: The influence of contamination with dried blood and biologic tissue was examined while screw M6 was covered with a pulpous mixture of pig's blood, pig's muscle, and pig's fat tissue. Series 3: The influence of contamination with dried blood and biologic tissue was examined while female thread was covered with a pulpous mixture of pig's blood, pig's muscle, and pig's fat tissue. Series 4: The influence of cleaning of the contaminated female component was examined while female thread contamination (with a pulpous mixture of pig's blood, pig's muscle, and pig's fat tissue) was cleaned with 50 ml saline solution. Comparing series 1 with series 4, series 2 with series 4 and series 3 with series 4 statistical analysis showed a significant reduction of fractures of screw M6 (p-values <0.01). To avoid fracture of the screw M6 of the MRP Titan System we recommend cleaning the inner thread of the morse taper junction with saline solution before junction is fixed with the screw and the torque wrench.
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Affiliation(s)
- T Semmelmann
- 1Institute for Medical Technology, Ostbayerische Technische Hochschule (OTH) Amberg-Weiden, Weiden, Germany
| | - A Schuh
- 2Hospital of Trauma Surgery, Department of musculoskeletal research, Marktredwitz Hospital, Marktredwitz, Germany
| | - H Rottmann
- 3Faculty of Business Administration, Ostbayerische Technische Hochschule (OTH), Amberg-Weiden, Weiden, Germany; 4ifo Institute - Leibniz Institute for Economic Research at the University of Munich, Germany
| | | | - Ch Fleischmann
- 1Institute for Medical Technology, Ostbayerische Technische Hochschule (OTH) Amberg-Weiden, Weiden, Germany
| | - S Sesselmann
- 1Institute for Medical Technology, Ostbayerische Technische Hochschule (OTH) Amberg-Weiden, Weiden, Germany
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Schuh A, Koehl P, Sesselmann S, Goyal T, Benditz A. INCIDENTAL INTRAOSSEOUS CALCANEAL LIPOMA IN A PATIENT SUFFERING FROM PLANTARFASZIITIS. Georgian Med News 2022:37-39. [PMID: 36427838] [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: 06/16/2023]
Abstract
Intraosseous calcaneal lipoma is a rare benign bone tumor. The incidence of intraosseous lipoma involving the calcaneus has been noted to account for fewer than 8-15% of all intraosseous lipoma. The etiology of the lesion is unknown. A post-traumatic secondary bone reaction, healing bone infarct, and benign neoplasm have been discussed. The symptoms can be nonspecific, varying from dull, intermittent pain to activity-related plantar pain. This pain can predictably be misdiagnosed as plantar fasciitis. We present the case of a 49-year-old male patient suffering from plantar fasciitis for three months and incidental asymptomatic intraosseous calcaneal lipoma, which was diagnosed by x-ray and CT scan. As the patient was out of complaints, the typical CT findings we saw no indication for biopsy but recommended regular CT and MRI controls.;
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Affiliation(s)
- A Schuh
- 1Hospital of trauma surgery, Department of musculoskeletal research, Marktredwitz Hospital, Germany
| | - P Koehl
- 2Hospital of trauma surgery, Marktredwitz Hospital, Germany
| | - S Sesselmann
- 3Institute for Medical Engineering, OTH Technical University of Applied Sciences Amberg-Weiden, Germany
| | - T Goyal
- 4Department of Orthopaedics, All India Institute of Medical Sciences, Bathinda, Punjab, India
| | - A Benditz
- 5Hospital of trauma surgery, Department of orthopedics. Marktredwitz Hospital, Germany
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Schuh A, Koehl P, Sesselmann S, Goyal T, Benditz A. INTRAMUSCULAR MYXOMA OF THE BUTTOCK- A CASE REPORT. Georgian Med News 2022:40-42. [PMID: 36427839] [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: 06/16/2023]
Abstract
Intramuscular myxoma (IM) is a benign, soft tissue neoplasm of mesenchymal origin. IM is rare, with an incidence of between 0.1 and 0.13 in every 100,000 individuals. Onset is usually between the fourth and seventh decades of life, predominantly in women (70%). The thigh is the common site of involvement seen in 51% patients, followed by upper arm (9%), calf (7%), and rarely in buttocks. We present the case of a 63-year-old female patient with a 6-month history of a growing IM of the right buttock. Due to rapid tumor growth resection of the tumor was indicated to obtain histopathological examination and to rule out malignancy. Marginal surgical removal was performed. Histopathological examination brought the diagnosis of a big intramuscular myxoma. There is no recurrence at latest follow-up.
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Affiliation(s)
- A Schuh
- 1Hospital of trauma surgery, Department of musculoskeletal research, Marktredwitz Hospital, Germany
| | - P Koehl
- 2Hospital of trauma surgery, Marktredwitz Hospital, Germany
| | - S Sesselmann
- 3Institute for Medical Engineering, OTH Technical University of Applied Sciences Amberg-Weiden, Germany
| | - T Goyal
- 4Department of Orthopaedics, All India Institute of Medical Sciences, Bathinda, Punjab, India
| | - A Benditz
- 5Hospital of trauma surgery, Department of orthopedics. Marktredwitz Hospital, Germany
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Perino G, Sunitsch S, Huber M, Ramirez D, Gallo J, Vaculova J, Natu S, Kretzer JP, Müller S, Thomas P, Thomsen M, Krukemeyer MG, Resch H, Hügle T, Waldstein W, Böettner F, Gehrke T, Sesselmann S, Rüther W, Xia Z, Purdue E, Krenn V. Diagnostic guidelines for the histological particle algorithm in the periprosthetic neo-synovial tissue. BMC Clin Pathol 2018; 18:7. [PMID: 30158837 PMCID: PMC6109269 DOI: 10.1186/s12907-018-0074-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [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] [Received: 11/10/2017] [Accepted: 08/16/2018] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The identification of implant wear particles and non-implant related particles and the characterization of the inflammatory responses in the periprosthetic neo-synovial membrane, bone, and the synovial-like interface membrane (SLIM) play an important role for the evaluation of clinical outcome, correlation with radiological and implant retrieval studies, and understanding of the biological pathways contributing to implant failures in joint arthroplasty. The purpose of this study is to present a comprehensive histological particle algorithm (HPA) as a practical guide to particle identification at routine light microscopy examination. METHODS The cases used for particle analysis were selected retrospectively from the archives of two institutions and were representative of the implant wear and non-implant related particle spectrum. All particle categories were described according to their size, shape, colour and properties observed at light microscopy, under polarized light, and after histochemical stains when necessary. A unified range of particle size, defined as a measure of length only, is proposed for the wear particles with five classes for polyethylene (PE) particles and four classes for conventional and corrosion metallic particles and ceramic particles. RESULTS All implant wear and non-implant related particles were described and illustrated in detail by category. A particle scoring system for the periprosthetic tissue/SLIM is proposed as follows: 1) Wear particle identification at light microscopy with a two-step analysis at low (× 25, × 40, and × 100) and high magnification (× 200 and × 400); 2) Identification of the predominant wear particle type with size determination; 3) The presence of non-implant related endogenous and/or foreign particles. A guide for a comprehensive pathology report is also provided with sections for macroscopic and microscopic description, and diagnosis. CONCLUSIONS The HPA should be considered a standard for the histological analysis of periprosthetic neo-synovial membrane, bone, and SLIM. It provides a basic, standardized tool for the identification of implant wear and non-implant related particles at routine light microscopy examination and aims at reducing intra-observer and inter-observer variability to provide a common platform for multicentric implant retrieval/radiological/histological studies and valuable data for the risk assessment of implant performance for regional and national implant registries and government agencies.
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Affiliation(s)
- G. Perino
- Department of Pathology and Laboratory Medicine, Hospital for Special Surgery, 535 E 70th Street, New York, NY 10023 USA
| | - S. Sunitsch
- Medizinische Universität Graz, Institut für Pathologie, Graz, Austria
| | - M. Huber
- Pathologisch-bakteriologisches Institut, Otto Wagner Spital, Wien, Austria
| | - D. Ramirez
- Department of Pathology and Laboratory Medicine, Hospital for Special Surgery, 535 E 70th Street, New York, NY 10023 USA
| | - J. Gallo
- Department of Orthopaedics, Faculty of Medicine and Dentistry, University Hospital, Palacky University Olomouc, Olomouc, Czech Republic
| | - J. Vaculova
- Department of Pathology, Fakultni Nemocnice Ostrava, Ostrava, Czech Republic
| | - S. Natu
- Department of Pathology, University hospital of North Tees and Hartlepool NHS Foundation Trust, Stockton-on-Tees, UK
| | - J. P. Kretzer
- Labor für Biomechanik und Implantat-Forschung, Klinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Heidelberg, Heidelberg, Germany
| | - S. Müller
- MVZ-Zentrum für Histologie, Zytologie und Molekulare Diagnostik, Trier, Germany
| | - P. Thomas
- LMU Klinik, Klinik und Poliklinik für Dermatologie und Allergologie, Munich, Germany
| | - M. Thomsen
- Baden-Baden Klinik, Baden-Baden, Germany
| | | | - H. Resch
- Universitätsklinik für Unfallchirurgie und Sporttraumatologie, Salzburg, Austria
| | - T. Hügle
- Hôpital Orthopédique, Lausanne, Switzerland
| | - W. Waldstein
- Medizinische Universität Wien, AKH-Wien, Universitätsklinik für Orthopädie, Wien, Austria
| | - F. Böettner
- Adult Reconstruction and Joint Replacement Division, Hospital for Special Surgery, New York, NY USA
| | - T. Gehrke
- Helios Endo-Klinik, Hamburg, Germany
| | - S. Sesselmann
- Orthopädische Universitätsklinik Erlangen, Erlangen, Germany
| | - W. Rüther
- Klinik und Poliklinik für Orthopädie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Z. Xia
- Centre for Nanohealth, Swansea University Medical School, Singleton Park, Swansea, UK
| | - E. Purdue
- Hospital for Special Surgery, Research Institute, New York, NY USA
| | - V. Krenn
- MVZ-Zentrum für Histologie, Zytologie und Molekulare Diagnostik, Trier, Germany
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Beyer C, Zampetaki A, Lin NY, Kleyer A, Perricone C, Iagnocco A, Distler A, Langley S, Gelse K, Sesselmann S, Lorenzini R, Niemeier A, Swoboda B, Distler J, Santer P, Egger G, Willeit J, Mayr M, Schett G, Kiechl S. OP0003 Signature of Circulating Micrornas in Osteoarthritis. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.1839] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Sesselmann S, Söder S, Voigt R, Haag J, Grogan SP, Aigner T. DNA methylation is not responsible for p21WAF1/CIP1 down-regulation in osteoarthritic chondrocytes. Osteoarthritis Cartilage 2009; 17:507-12. [PMID: 18954998 DOI: 10.1016/j.joca.2008.09.006] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2008] [Accepted: 09/12/2008] [Indexed: 02/02/2023]
Abstract
OBJECTIVE In this study, we were interested in the overall methylation level in aged and degenerated cartilage. Also, we looked at one gene which might be involved in the re-initiation of replicative activity in osteoarthritis (OA) chondrocytes, p21(WAF1/CIP1). p21(WAF1/CIP1) was previously suggested to be down-regulated in OA chondrocytes and is known to be regulated by epigenetic modulation. METHODS Total methylation levels were analyzed by high pressure liquid chromatography (HPLC), mRNA expression of p21(WAF1/CIP1) and DNMT enzymes by real-time polymerase chain reaction. The methylation status of the p21(WAF1/CIP1)- promotor using bisulfite genomic sequencing was evaluated. RESULTS General methylation analysis of genomic DNA showed no difference in between normal and aged/OA chondrocytes. Also no difference in methylation of the promotor of the p21(WAF1/CIP1) gene was detectable, which was significantly down-regulated in OA chondrocytes. DNMT1 and DNMT3a were expressed with no significant changes of expression levels found in OA chondrocytes. CONCLUSION Cell cycle progression inhibitor p21(WAF1/CIP1) is expressed in normal and significantly down-regulated in OA articular chondrocytes, which may mediate the re-initiation of cell proliferation in OA cartilage. However, the suppression of p21(WAF1/CIP1) mRNA expression is not due to hypermethylation of its promotor. No overall changes in genome methylation levels were found in aged or OA cartilage. Interestingly, significant expression of DNA methyltransferases was found in articular chondrocytes, which supports that DNA methylation could still be a relevant mechanism of gene regulation in (osteoarthritic) chondrocytes, though not on an overall genomic level nor specifically for the regulation of the p21(WAF1/CIP1) gene.
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Affiliation(s)
- S Sesselmann
- Institute of Pathology, University Hospital Erlangen, Krankenhausstr. 12, 91054 Erlangen, Germany
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