著者

渡辺 公三 玉井 和哉 吉田 耕志郎

出版者

Japan Shoulder Society

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.16, no.1, pp.47-49, 1992

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We set up Isometric exercises for patients with a glenohumeral joint contracture to do. The series of exercises consists of an abduction and an external rotation every 5 seconds, and internal rotation movements with a 5-second-rest interposed between each movement.<BR>The patients were ordered to keep their shoulders in the neut r al position while doing these exercises. We demanded that they do these exercises for about 10 minutes, twice a day at least.<BR>No patients had any local analgesics injected into their subacromial bursanor glenohumeral joint during this 4-week-isometric contraction exercise period.<BR>Loxoprofen sodium was prescribed as a painkiller when the patients wanted it.4 weeks later, we investigated the effects of these exercises in the relief of pain and recovery of motion.3 levels of pain were used in this study: better, no change, worse, compared with the pain the patients had when they started these exercises. The range of motion was indicated in total degrees of flexion, abduction and external rotation.<BR>Considering a margin of error, a 20-degree-increase or even from the beginning was considered as an -Improvement- and a 20-degree-decrease or even was considered as an -Aggravation-.<BR>We investigated 29 patients' 30 shoulders aged 56.9 years old on average. A relief of pain was observed in 64% of the patients and a recovery of motion in 67%.

著者

浜田 純一郎 大野 弥 玉井 和哉

出版者

日本肩関節学会

雑誌

肩関節 = Shoulder joint (ISSN:09104461)

巻号頁・発行日

vol.26, no.2, pp.309-314, 2002-01-01

参考文献数

8

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The purpose of this study was to identify whether the glenohumeral joint (GHj) or subacromial bursa (SAB) is the main inflamed site, and which pathway should be operated on for the degradation of the articular cartilage after a cuff tear. We obtained synovial fluid, SAB, the stump of a torn supraspinatus tendon (cuff), synovium, and articular cartilage (cartilage) from 8 patients with a complete-thickness tear. As a control, the cuff and cartilage were removed from 2 patients with tumors around the shoulders. We measured the concentration of interleukin-1 &beta; (IL-1 &beta;), IL-6, matrix metalloproteinase-1 (MMP-1), MMP-3. Immunohistochemical localization with antibodies to proliferative cell nuclear antigen (PCNA), IL-1 &beta;, IL-6 and MMP-3 was performed using the ABC immunoperoxidase method. Concentrations of IL-1 &beta; were 4.8&plusmn;4.3 pg/ml, IL-6 485&plusmn;4.3 pg/ml, MMP-1 417&plusmn;330 ng/ml, MMP-3 6105&plusmn;4258 ng/ml. A few nuclei were stained by PCNA but no cell by IL-1 &beta;, IL-6, or MMP-3 in the control tissues. IL-1 &beta; immunoreactivity was highest in the following order synovium, cuff, SAB, and cartilage ; for IL-6 the order was synovium, cuff, and SAB ; for MMP-3 in the order was synovium and cuff. Even though we found the same pathological findings (hyperplasia and abundant blood vessels) between the SAB and the synovium, expression of both IL-1 &beta; and MMP-3 were much higher in the synovium than in the SAB. We conclude from these results that GHj is the main inflamed site after a cuff tear, and the extrinsic pathway is more greatly operated than the intrinsic pathway to cartilage degradation.

著者

矢野 雄一郎 玉井 和哉 野原 裕 吉崎 邦夫 浜田 純一郎

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.32, no.2, pp.241-244, 2008 (Released:2008-08-30)

参考文献数

6

被引用文献数

1

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To clear whether healthy subjects elevate and lowered their dominant and non dominant shoulder joints in the same manner or not was significantly valuable to understand the pathology of shoulder diseases: rotator cuff tear; impingement syndrome; stiff shoulder; and loose shoulder. 20 young healthy participants (17 males and 3 females, average age 22.6 years old) participated in this study. They randomly elevated and lowered both shoulder joints in the scapular plane at three times and were recorded by 3 dimensional motion analyzer. We calculated the scapulohumeral rhythm in each 10° and analyzed the setting phase. There was statistically no significant difference in the scapulohumeral rhythm between the dominant and non dominant shoulders. Scapulohumeral rhythm was stable (3.5) from 60° in elevation to 50° in lowering, however, individual variation of scapulohumeral rhythm (more than 3.5) was identified except the previous shown angles. To elevate both shoulder joints in the same manner mean that we can compare both shoulders about the scapula motion and arm elevation in patients with shoulder disorders. The setting phase is defined as until 60° in elevation, and moreover, a similar phase as the setting phase with various scapular motion is recognized in the lowering motion.