Histology of the extensor retinaculum of the wrist and the ankle.

The extensor retinaculum of the wrist has been used for reconstruction of the annular pulleys of the flexor sheath. We examined the histologic structure of the extensor retinaculum and tendon sheath of the wrist and ankle in cadaveric specimens using hematoxylin-eosin and Verhoeff-van Gieson stains to detect elastin and alcian blue to detect hyaluronic acid, comparing the structure with that described previously for the annular pulleys. Three distinct layers are identified in the retinaculums of both the ankle and wrist: the inner gliding layer, with hyaluronic acid-secreting cells, shows isolated chondroid metaplasia; the thick middle layer contains collagen bundles, fibroblasts, and interspersed elastin fibers; and the outer layer consists of loose connective tissue containing vascular channels. This basic 3-layered histologic composition of the extensor retinaculum is carried in anatomic pulleys throughout the body and appears to represent an adaptive mechanism to provide both a smooth gliding surface as well as the mechanical strength to prevent tendon bowstringing. Given the same histologic structure as the annular pulleys, the extensor retinaculum is a reasonable biologic replacement for the reconstruction of deficient annular pulleys. Likewise, the extensor retinaculum of the ankle could be used to reconstruct a deficient retinaculum of the wrist.     

A strategy to improve treatment‐related mortality and abandonment of therapy for childhood ALL in a developing country reveals the impact of treatment delays

Background

Treatment‐related mortality and abandonment of therapy are major barriers to successful treatment of childhood acute lymphoblastic leukemia (ALL) in the developing world.

Procedure

A collaboration was undertaken between Instituto Nacional de Cancerologia (Bogota, Colombia), which serves a poor patient population in an upper‐middle income country, and Dana‐Farber/Boston Children's Cancer and Blood Disorders Center (Boston, USA). Several interventions aimed at reducing toxic deaths and abandonment were implemented, including a reduced‐intensity treatment regimen and a psychosocial effort targeting abandonment. We performed a cohort study to assess impact.

Results

The Study Population comprised 99 children with ALL diagnosed between 2007 and 2010, and the Historic Cohort comprised 181 children treated prior to the study interventions (1995–2004). Significant improvements were achieved in the rate of deaths in complete remission (13% to 3%; P = 0.005), abandonment (32% to 9%; P < 0.001), and event‐free survival with abandonment considered an event (47% to 65% at 2 years; P = 0.016). However, relapse rate did not improve. Medically unnecessary treatment delays were common, and landmark analysis revealed that initiating the PIII phase of therapy ≥4 weeks delayed predicted markedly inferior disease‐free survival (P = 0.016). Conversely, patients who received therapy without excessive delays had outcomes approaching those achieved in high‐income countries.

Conclusions

Implementation of a twinning program was followed by reductions in abandonment and toxic deaths, but relapse rate did not improve. Inappropriate treatment delays were common and strongly predicted treatment failure. These findings highlight the importance of adherence to treatment schedule for effective therapy of ALL. Pediatr Blood Cancer 2015;62:1395–1402. © 2015 Wiley Periodicals, Inc.     

Long-term analysis of the palliative benefit of 2-chlorodeoxyadenosine for myelofibrosis with myeloid metaplasia

OBJECTIVE: Therapeutic splenectomy in myelofibrosis with myeloid metaplasia (MMM) may result in extreme thrombocytosis and leukocytosis and accelerated hepatomegaly. We previously described initial palliative benefit from 2-chlorodeoxyadenosine (2-CdA) in such instances. The purpose of this study is to provide long-term follow-up on the durability of response in the initial cohort and in additional subsequent cases. METHODS: We retrospectively identified patients with histologically confirmed MMM who had palliative therapy with 2-CdA. Clinical characteristics and information on subsequent clinical course were abstracted at the time of diagnosis of MMM and at initiation of 2-CdA therapy until death. RESULTS: To date, we have used 2-CdA as palliative therapy in 14 patients with MMM. After a median of four cycles of therapy, responses for hepatomegaly occurred in 56% of patients, thrombocytosis 50%, leukocytosis 55%, and anemia 40%. Cytopenias were frequent but usually transient and without clinical consequence. Responses occurred usually by the second cycle; median duration of response was 6 months (range, 2-19) after completion of 2-CdA therapy. CONCLUSION: This study confirmed relevant and frequently durable palliation of symptoms in about half the patients. 2-CdA is a reasonable palliative option in postsplenectomy patients with MMM who have problematic myeloproliferation.     

Viruses in Extreme Environments,Current Overview,and Biotechnological Potential

Virus research has advanced significantly since the discovery of the tobacco mosaic virus (TMV), the characterization of its infection mechanisms and the factors that determine their pathogenicity. However, most viral research has focused on pathogenic viruses to humans, animals and plants, which represent only a small fraction in the virosphere. As a result, the role of most viral genes, and the mechanisms of coevolution between mutualistic viruses, their host and their environment, beyond pathogenicity, remain poorly understood. This review focuses on general aspects of viruses that interact with extremophile organisms, characteristics and examples of mechanisms of adaptation. Finally, this review provides an overview on how knowledge of extremophile viruses sheds light on the application of new tools of relevant use in modern molecular biology, discussing their value in a biotechnological context.     

Dermatoglyphics of inhabitants of Alberche/Tormes valley (Sierra de Gredos-Central Spain): I. Finger pattern types and pattern intensity

The incidence of dermatoglyphic finger patterns and pattern intensity in a sample of school children from the Alberche/Tormes valley (northern slope of the Sierra de Gredos, Central Spain) are described. Significant bilateral differences for the overall finger pattern incidence are found in both sexes. The differences between sexes are also statistically significant, except for the left hand. The Pattern Intensity Index significantly differs between hands of males only, and the sex differences are not significant. Variation ranges for fingertip patterns and pattern intensity were constructed using published data of 69 male and 62 female series drawn from the whole of the Iberian Peninsula. The overall incidence of fingertip patterns and the Pattern Intensity Index locate the studied population near the middle of the corresponding variation ranges. The only exception is the case of arches, for which Alberche/Tormes is close to the minimum value of the range of variation. A more detailed comparison of 10 male and 10 female series from the Spanish northern and southern plateaus and from the Spanish region of Extremadura was done with R-matrix analysis. The series compared include those from the northern slope (Alberche/Tormes valley, this study) and the southern slope (Tiétar valley) of the Sierra de Gredos. The observed degree of dermatoglyphic differentiation between these two series may be explained by taking into account both the role of the Sierra de Gredos as a biological barrier limiting gene flow and the evolutionary stability of dermatoglyphics. © 1996 Wiley-Liss, Inc.     

Effect of chronic intake of ethanol on the binding of vasoactive intestinal peptide to rat spleen lymphoid cells

1. The effect of chronic intake of ethanol on the binding of vasoactive intestinal peptide (VIP) to rat spleen lymphoid cells was investigated. 2. The intake chronic of ethanol elicited an increase in specific VIP binding. 3. This increase was due to an increase in binding capacity of both the high and the low affinity binding sites. 4. There was a decrease in the affinities of both classes of VIP binding sites.     

Efficacy of regenerative therapy in aggressive periodontitis: a systematic review and meta-analysis of randomised controlled clinical trials

Clinical Oral Investigations - To analyse evidence regarding the efficacy of periodontal regenerative procedures in intrabony defects in patients treated for aggressive periodontitis (AgP). A...