Browsing by Author "Cheng, Cheng-Kung"

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Biomechanical comparison of instrumented posterior lumbar interbody fusion with one or two cages by finite element analysis
(2006-09-01)
Chiang, Ming-Fu
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Zhong, Zheng-Cheng
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Chen, Chen-Sheng
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Cheng, Cheng-Kung
;
Shih, Shih-Liang
Study Design. Using finite element models to study the biomechanics of lumbar instrumented posterior lumbar interbody fusion (PLIF) with one or two cages. Objective. Analyzing the biomechanics of instrumented PLIF with one or two cages as to evaluate whether a single cage is adequate for instrumented PLIF. Summary of Background Data. Implantation of a single cage in instrumented PLIF of lumbar spine is still controversial. Methods. Three validated finite element models of L3-L5 lumbar segment were established [intact model (INT), one cage model (LS-1), and two cages model (LS-2)]. The available finite element program ANSYS 6.0 (Swanson Analysis System Inc., Houston, TX) was applied. To analyze the biomechanics of these models, 10 Nm flexion, extension, rotation, and lateral bending moment with 150 N of preload were respectively imposed on the superior surfaces of the L3. Results. Compared with the INT model, the decrease of ROM in the LS-1 and LS-2 models were exaggerated from 0.67 degrees to 3.73 degrees and ranged from 37.2% to 86.1% in all motions. The mean subsidence was found to be slightly higher in the LS-1 model. Most of the cage dislodgement in both models was less than 0.03 mm. The mean dislodgement was slightly higher in the LS-1 model. The stress of cage was found to be high in the LS-2 model. The mean stress of screw was raised to 4.5% to 9.7% in the LS-1, which was higher than that in the LS-2 model. In general, stress of adjacent disc was more pronounced in the LS-2 model. The most stress distributed at the anterior portion of the adjacent disc, which could be used to interpret the clinical findings of the early adjacent disc degeneration. Conclusions. A single cage inserted in an instrumented PLIF gains approximate biomechanical stability, slight greater subsidence, and a slight increase in screw stress but less early degeneration in adjacent disc. Adjusting these factors, instrumented PLIF with one cage could be encouraged in clinical practice.
BMP-4 Induction of Arrest and Differentiation of Osteoblast-Like Cells via p21(CIP1) and p27(KIP1) Regulation
(2009-11-01)
Chang, Shun-Fu
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Chang, Ting-Kuo
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Peng, Hsin-Hsin
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Yeh, Yi-Ting
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Lee, Ding-Yu
Cell cycle regulation by differentiation signals is critical for eukaryote development. We investigated the roles of bone morphogenetic protein (BMP)-4, an important stimulator of osteoblast differentiation and bone formation, in regulating cell cycle distribution in four osteoblast-like cell lines and mouse primary osteoblasts, and the underlying mechanisms. In all cells used, BMP-4 induced G(0)/G(1) arrest. The molecular basis of the BMP-4 effect was analyzed, and the presentation on molecular mechanism is focused on human MG63 cells. BMP-4 induced p21(CIP1) and p27(KIP1) expressions and hence cell differentiation but had no effects on the expressions of cyclins A, B1, D1, and E, cyclin-dependent protein kinase-2, -4, and -6. Using specific small interfering RNA (siRNA), we found that BMP-4-induced G(0)/G(1) arrest, and p21(CIP1) and p27(KIP1) expressions were mediated by BMP receptor type IA (BMPRIA)-specific Sma- and Mad-related protein (Smad)1/5. BMP-4 induced transient phosphorylations of ERK; transfection of MG63 cells with ERK2, but not ERK1, -specific siRNA inhibited the BMP-4-induced responses in MG63 cells. Pretreatment of MG63 cells with Arg-Gly-Asp-Ser, which blocks the cell-extracellular matrix interaction, or transfection with beta(3) integrin-specific siRNA inhibited BMP-4-induced ERK and Smad1/5 phosphorylations. BMP-4 induced transient increases in associations of beta(3)-integrin with focal adhesion kinase and Shc, the dominant-negative mutants of which inhibited BMP-4-induced ERK and Smad1/5 phosphorylations. Our results indicate that BMP-4 induces G(0)/G(1) arrest and hence differentiation in osteoblast-like cells through increased expressions of p21(CIP1) and p27(KIP1), which are mediated by BMPRIA-specific Smad1/5. The extracellular matrix/beta(3) integrin/focal adhesion kinase/Shc/ERK2 signaling pathway is involved in these BMP-4-induced responses in osteoblast-like cells. (Molecular Endocrinology 23: 1827-1838, 2009)
Tumor cell cycle arrest induced by shear stress: Roles of integrins and Smad
(2008-03-11)
Chang, Shun-Fu
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Chang, Cheng Allen
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Lee, Ding-Yu
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Leet, Pei-Ling
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Yeh, Yu-Ming
interstitial flow in and around tumor tissue affects the mechanical microenvironment to modulate tumor cell growth and metastasis. We investigated the roles of flow-induced shear stress in modulating cell cycle distribution in four tumor cell lines and the underlying mechanisms. In all four cell lines, incubation under static conditions for 24 or 48 h led to G(0)/G(1) arrest; in contrast, shear stress (12 dyneS/cm(2)) induced G(2)/M arrest. The molecular basis of the shear effect was analyzed, and the presentation on molecular mechanism is focused on human MG63 osteosarcoma cells. Shear stress induced increased expressions of cyclin 11311 and p21(CIP1) and decreased expressions of cyclins A, D1, and E, cyclin-dependent protein kinases (Cdk)-1, -2, -4, and -6, and p27(KIP1) as well as a decrease in Cdk1 activity. Using specific antibodies and small interfering RNA, we found that the shear-induced G2/M arrest and corresponding changes in G2/M regulatory protein expression and activity were mediated by alpha(v)beta(3) and beta(1), integrins through bone morphogenetic protein receptor type IA-specific Smad1 and Smad5. Shear stress also down-regulated runt-related transcription factor 2 (Runx2) binding activity and osteocalcin and alkaline phosphatase expressions in MG63 cells; these responses were mediated by alpha(v)beta(3) and beta(1), integrins through Smad5. Our findings provide insights into the mechanism by which shear stress induces G(2)/M arrest in tumor cells and inhibits cell differentiation and demonstrate the importance of mechanical microenvironment in modulating molecular signaling, gene expression, cell cycle, and functions in tumor cells.
Wing-augmentation reduces femoral head cutting out of dynamic hip screw
(2017-06-01)
Chen, Chih-Yu
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Huang, Shu-Wei
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Sun, Jui-Sheng
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Lin, Shin-Yiing
;
Yu, Chih-Sheng
The dynamic hip screw (DHS) is commonly used in the treatment of femoral intertrochanteric fracture with high satisfactory results. However, post-operative failure does occur and result in poor prognosis. The most common failure is femoral head varus collapse, followed by lag screw cut-out through the femoral head. In this study, a novel-designed DHS with two supplemental horizontal blades was used to improve the fixation stability. In this study, nine convention DHS and 9 Orthopaedic Device Research Center (ODRC) DHSS were tested in this study. Each implant was fixed into cellular polyurethane rigid foam as a surrogate of osteoporotic femoral head. Under biaxial rocking motion, all constructs were loaded to failure point (12 mm axial displacement) or up to 20,000 cycles of 1.45 kN peak magnitude were achieved, whichever occurred first. The migration kinematics was continuously monitored and recorded. The final tip-to-apex distance, rotational angle and varus deformation were also recorded. The results showed that the ODRC DHS sustained significantly more loading cycles and exhibited less axial migration in comparison to the conventional DHS. The ODRC DHS showed a significantly smaller bending strain and larger torsional strain compared to the conventional DHS. The changes in tip-to-apex distance (TAD), post-study varus angle, post-study rotational angle of the ODRC DHS were all significantly less than that of the conventional DHS (p < 0.05). We concluded that the ODRC DHS augmented with two horizontal wings would increase the bone-implant interface contact surface, dissipate the load to the screw itself, which improves the migration resistance and increases the anti-rotational implant effect. In conclusion, the proposed ODRC DHS demonstrated significantly better migration resistance and anti-rotational effect in comparison to the conventional DHS construct. (C) 2017 IPEM. Published by Elsevier Ltd. All rights reserved.