This blog is devoted to BIOL 6988, a graduate level seminar in the biological sciences at Youngstown State University. While targeted towards graduate students, BIOL 6988 actively incorporates undergraduate participants in their scholastic endeavors in the biological sciences. This blog is intended as a educational tool not just for YSU students and faculty, but for anyone who wishes to contribute to an active-learning environment.
Welcome back from Spring Break!!!! This week, both Efran Uddin and Chris Hammond are presenting at seminar. Please attend and comment on their presentations below.
Chris and Erfan both did a fantastic job on Friday! In Chris’ presentation I was surprised to learn that the Tommy-John surgery would not only heal the torn UCL of professional athletes, but in some cases athletes would gain functional use of their arm that was superior to the ability they had prior to injury ultimately extending their careers. In Erfan’s presentation it was interesting to learn about the role collagen plays in wound healing, and how the oxidation of it could have a negative effect.
I have two questions. The first in regards to Chris’ topic: Do you see the Tommy-John surgery becoming an outdated method to fix UCL tears with advancements in regenerative medicine? The second in regards to Erfan’s topic: How could TGF-β protect collagen from being oxidized?
I don't think Tommy Johhn surgery will be considered outdated simply because it's only recommendable to athletes who don't respond first to non-surgical therapies such as rest and ice.This procedure takes only a year to two for the patient to return to normal level of ability and this may depend with age,for instance ,younger athletes may take shortest possible time to heal as compared to older athletes.Few cases of complications have been reported 5-20% of the patients and this can be corrected in an additional surgery.
The TGB-beta is important in collagen regulation and the exposure of the cells to exogenous oxidants or raising endogenous levels of oxidants cause multitude of responses,depending on the nature of the oxidants and the cell types such as activation of the MAP signalling pathway and the alteration of the exogenous oxidants which can be achieved by either depletion of one or more antioxidant enzymes. Over expression of catalase in mitochondria has been shown to reduce the endogenous levels of hydrogen peroxide and extend the lifespan of transgenic mice.
Rooseline is correct! In my research part we have been actually looking at the methionine residue in collagen which is more prone to become oxidized due to the presence of sulfer in its structure. We are hypothesizing that TGF- β, a growth factor, would protect the methionine residue not being oxidized so that it would not cleave by protease and make a stable collagen which would ultimately help in faster wound healing.
First of all, let me just say that I was also very impressed by both presentations. Although I had certainly heard of it before, I knew very little about what Tommy John surgery actually entailed. Chris did a thorough job of explaining all the background anatomy before moving on to the specifics of the procedure. Erfan was very clear in his explanations and showed enviable poise in his presentation.
I would like to go deeper into one aspect of Chris’ research which I found particularly interesting. The thing that surprised me the most about the surgery was that a tendon is used to replace a ligament. Although I know that they are very similar tissues, a brief examination of the topic shows that there are some histological and biochemical differences between them. I wonder if there are any complications associated with the alteration in tendon function utilized by the procedure?
I concur that both presentations were exceptionally well done and interesting. Both presenters seemed very knowledgeable of their material and confident in their presentational skills. I read that, in the past, there was a misconception about the Tommy John surgery in that some athletes who underwent the surgery had a better performance level after than they did before, and some uninjured athletes sought medical professionals to perform the surgery despite their lack of injury, for this competitive reason. I wonder if the above and beyond restoration is true in some cases, and if it has anything to do with the differences in the replaced tissue with the UCL, like Marshall questioned.
I agree that both presenters did an amazing job! Although, the surgery requires replacement of a ligament with a tendon, I do not see that as the reason for limited functionality post operation. Surgery of any kind to repair an injured body part, rarely ends up with full functionality. From the information provided in the presentation, the surgery seems to be exceptional, in the fact that many players are able to return to playing at all after it.
Good Job Chris and Erfan. I agree with Jillian, i have heard similar stories of athletes who underwent surgery coming back stronger than ever. Maybe it has to do with the rehab process; strengthening the surrounding muscles more than the athletes normally do if they were never injured. They perform a lot of band work and minor muscle strengthening exercises that could help in velocity when throwing.
Coming from the medical field (kind of...working in a lab counts, right?), the common story seems to be that if you don't complete physical therapy post repair surgery then you will never be as strong as you were. However, it seems that most who complete rehab properly seem to come back as strong and occasionally stronger. Most of the physicians I've spoken to about this seem to think that the "strengthening" exercises are what help the most, but most people don't get around to those and have dropped out of rehab prior because they "are back to normal".
In reference to the misconception that Jillian brought up, what Bill replied with was in line with what I found is some of the research literature. Players that undergo the UCL reconstruction and come back throwing harder than before will often pay much greater attention to their conditioning and arm care after their UCL was torn. Also, the players that threw harder also seemed to be younger and were still developing, as opposed to pitchers that were older who tore their UCL and were already starting to lose velocity.
In reference to Marshall's point about the differences between the tendon and ligament, the portion of the UCL that is torn and replaced is strong and cord-like. The tendon used also has a good tensile strength similar to the anterior portion of the UCL with is why it is able to be used in the surgery. Also, the way the surgeon implants the tendon, with the tunnels and figure 8 design, helps stabilize the medial elbow.
Both Erfan and Chris did great! I have to say, being a former pitcher, I found Chris' talk hitting close to home. Although I have never had any issues with my elbows (because we pitch underhand), I have had shoulder problems due to overhand throwing. I have never had any players I know have any UCLs that were torn, but again that is understandable in softball, because even the third basemen do not throw as repetitively overhand and as often as a male pitcher does. I believe that the surgery will be continued to be used because it has provided great benefit (more than expected from what I have read) to pitchers and players with torn UCLs. Again with surgeries, most of the time, you can not expect to come back 100% from it, but it is always great on the off chance it does happen.
I agree both Erfan and Chris did great! I loved learning more about the anatomy of the elbow and how it works. I didn't know the ligament that's being tore is called the ulnar collateral ligament and that its composed of 3 parts, Anterior Posterior and oblique. He wasn't really sure what arm ligament they take out if its on the same side or if its on the opposite side. He seemed kind of nervous or unsure when he answered someone's question.
Chris and Erfan both did a fantastic job on Friday! In Chris’ presentation I was surprised to learn that the Tommy-John surgery would not only heal the torn UCL of professional athletes, but in some cases athletes would gain functional use of their arm that was superior to the ability they had prior to injury ultimately extending their careers. In Erfan’s presentation it was interesting to learn about the role collagen plays in wound healing, and how the oxidation of it could have a negative effect.
ReplyDeleteI have two questions. The first in regards to Chris’ topic: Do you see the Tommy-John surgery becoming an outdated method to fix UCL tears with advancements in regenerative medicine? The second in regards to Erfan’s topic: How could TGF-β protect collagen from being oxidized?
I don't think Tommy Johhn surgery will be considered outdated simply because it's only recommendable to athletes who don't respond first to non-surgical therapies such as rest and ice.This procedure takes only a year to two for the patient to return to normal level of ability and this may depend with age,for instance ,younger athletes may take shortest possible time to heal as compared to older athletes.Few cases of complications have been reported 5-20% of the patients and this can be corrected in an additional surgery.
ReplyDeleteThe TGB-beta is important in collagen regulation and the exposure of the cells to exogenous oxidants or raising endogenous levels of oxidants cause multitude of responses,depending on the nature of the oxidants and the cell types such as activation of the MAP signalling pathway and the alteration of the exogenous oxidants which can be achieved by either depletion of one or more antioxidant enzymes. Over expression of catalase in mitochondria has been shown to reduce the endogenous levels of hydrogen peroxide and extend the lifespan of transgenic mice.
Rooseline is correct! In my research part we have been actually looking at the methionine residue in collagen which is more prone to become oxidized due to the presence of sulfer in its structure. We are hypothesizing that TGF- β, a growth factor, would protect the methionine residue not being oxidized so that it would not cleave by protease and make a stable collagen which would ultimately help in faster wound healing.
ReplyDeleteFirst of all, let me just say that I was also very impressed by both presentations. Although I had certainly heard of it before, I knew very little about what Tommy John surgery actually entailed. Chris did a thorough job of explaining all the background anatomy before moving on to the specifics of the procedure. Erfan was very clear in his explanations and showed enviable poise in his presentation.
ReplyDeleteI would like to go deeper into one aspect of Chris’ research which I found particularly interesting. The thing that surprised me the most about the surgery was that a tendon is used to replace a ligament. Although I know that they are very similar tissues, a brief examination of the topic shows that there are some histological and biochemical differences between them. I wonder if there are any complications associated with the alteration in tendon function utilized by the procedure?
I concur that both presentations were exceptionally well done and interesting. Both presenters seemed very knowledgeable of their material and confident in their presentational skills. I read that, in the past, there was a misconception about the Tommy John surgery in that some athletes who underwent the surgery had a better performance level after than they did before, and some uninjured athletes sought medical professionals to perform the surgery despite their lack of injury, for this competitive reason. I wonder if the above and beyond restoration is true in some cases, and if it has anything to do with the differences in the replaced tissue with the UCL, like Marshall questioned.
ReplyDeleteI agree that both presenters did an amazing job! Although, the surgery requires replacement of a ligament with a tendon, I do not see that as the reason for limited functionality post operation. Surgery of any kind to repair an injured body part, rarely ends up with full functionality. From the information provided in the presentation, the surgery seems to be exceptional, in the fact that many players are able to return to playing at all after it.
ReplyDeleteGood Job Chris and Erfan. I agree with Jillian, i have heard similar stories of athletes who underwent surgery coming back stronger than ever. Maybe it has to do with the rehab process; strengthening the surrounding muscles more than the athletes normally do if they were never injured. They perform a lot of band work and minor muscle strengthening exercises that could help in velocity when throwing.
ReplyDeleteComing from the medical field (kind of...working in a lab counts, right?), the common story seems to be that if you don't complete physical therapy post repair surgery then you will never be as strong as you were. However, it seems that most who complete rehab properly seem to come back as strong and occasionally stronger. Most of the physicians I've spoken to about this seem to think that the "strengthening" exercises are what help the most, but most people don't get around to those and have dropped out of rehab prior because they "are back to normal".
ReplyDeleteIn reference to the misconception that Jillian brought up, what Bill replied with was in line with what I found is some of the research literature. Players that undergo the UCL reconstruction and come back throwing harder than before will often pay much greater attention to their conditioning and arm care after their UCL was torn. Also, the players that threw harder also seemed to be younger and were still developing, as opposed to pitchers that were older who tore their UCL and were already starting to lose velocity.
ReplyDeleteIn reference to Marshall's point about the differences between the tendon and ligament, the portion of the UCL that is torn and replaced is strong and cord-like. The tendon used also has a good tensile strength similar to the anterior portion of the UCL with is why it is able to be used in the surgery. Also, the way the surgeon implants the tendon, with the tunnels and figure 8 design, helps stabilize the medial elbow.
Both Erfan and Chris did great!
ReplyDeleteI have to say, being a former pitcher, I found Chris' talk hitting close to home. Although I have never had any issues with my elbows (because we pitch underhand), I have had shoulder problems due to overhand throwing. I have never had any players I know have any UCLs that were torn, but again that is understandable in softball, because even the third basemen do not throw as repetitively overhand and as often as a male pitcher does. I believe that the surgery will be continued to be used because it has provided great benefit (more than expected from what I have read) to pitchers and players with torn UCLs. Again with surgeries, most of the time, you can not expect to come back 100% from it, but it is always great on the off chance it does happen.
I agree both Erfan and Chris did great! I loved learning more about the anatomy of the elbow and how it works. I didn't know the ligament that's being tore is called the ulnar collateral ligament and that its composed of 3 parts, Anterior Posterior and oblique. He wasn't really sure what arm ligament they take out if its on the same side or if its on the opposite side. He seemed kind of nervous or unsure when he answered someone's question.
ReplyDelete