Orthopedic cervical headgear with an expanded inner bow in class II correction

Forty consecutively referred children, 20 boys and 20 girls, with a Class II division I malocclusion and protrusive maxilla were treated with orthopedic cervical headgear with a 10 mm expanded inner bow and a long outer bow bent 15 degrees upwards. The mean age of the children at the beginning of treatment was 9.3 years (SD 1.3, range 6.6 to 12.4 years), and the average treatment time was 1.8 years (SD 0.6, range 0.8 to 3.1 years). In all patients Class II molar relationships were successfully corrected to Class I molar relationships. This was accompanied by a marked widening of both maxillary and mandibular dental arches. The cephalometric analysis suggested that the observed improvement of the occlusion was due to an inhibition of forward growth of the maxilla and anterior downward rotation of the palate.     

How to Bury the Dead: Elimination of Apoptotic Hair Cells from the Hearing Organ of the Mouse

Hair cell death is a major cause of hearing impairment. Preservation of surface barrier upon hair cell loss is critical to prevent leakage of potassium-rich endolymph into the organ of Corti and to prevent expansion of cellular damage. Understanding of wound healing in this cytoarchitecturally complex organ requires ultrastructural 3D visualization. Powered by the serial block-face scanning electron microscopy, we penetrate into the cell biological mechanisms in the acute response of outer hair cells and glial-like Deiters’ cells to ototoxic trauma in vivo. We show that Deiters’ cells function as phagocytes. Upon trauma, their phalangeal processes swell and the resulting close cellular contacts allow engulfment of apoptotic cell debris. Apical domains of dying hair cells are eliminated from the inner ear sensory epithelia, an event thought to depend on supporting cells’ actomyosin contractile activity. We show that in the case of apoptotic outer hair cells of the organ of Corti, elimination of their apices is preceded by strong cell body shrinkage, emphasizing the role of the dying cell itself in the cleavage. Our data reveal that the resealing of epithelial surface by junctional extensions of Deiters’ cells is dynamically reinforced by newly polymerized F-actin belts. By analyzing Cdc42-inactivated Deiters’ cells with defects in actin dynamics and surface closure, we show that compromised barrier integrity shifts hair cell death from apoptosis to necrosis and leads to expanded hair cell and nerve fiber damage. Our results have implications concerning therapeutic protective and regenerative interventions, because both interventions should maintain barrier integrity.     

The incidence of knee arthroplasty for primary osteoarthritis grows rapidly among baby boomers: A population‐based study in Finland

Objective

Total knee arthroplasty (TKA) is a commonly used treatment for severe primary knee osteoarthritis (OA) that is refractory to conservative treatment. Despite the presumed increase in the use of this treatment modality in younger patients, there are few published data concerning this. The aim of our study was to examine the changes in the age‐ and sex‐standardized incidence of TKA and unicondylar knee arthroplasty (UKA) in Finland during 1980–2006 and to identify factors that might affect the incidence during this period.

Methods

We obtained data on UKAs and TKAs from the Finnish Arthroplasty Registry and population data from Statistics Finland to analyze the incidence of UKAs and TKAs in Finland for the period 1980–2006. The effects of sex, age group, and hospital volume on the incidence of these procedures were also evaluated.

Results

The annual cumulative incidence of UKAs and TKAs has increased rapidly from 1980 to 2006 among 30–59‐year‐old inhabitants of Finland. For UKAs, the incidence increased from 0.2 per 100,000 inhabitants to 10 per 100,000, and for TKAs, the incidence increased from 0.5 per 100,000 to 65 per 100,000. The incidence remained higher among women during the entire study period. Most of the increase occurred among patients ages 50–59 years. The incidence grew more rapidly in low‐volume and intermediate‐volume hospitals.

Conclusion

We demonstrated a rapid increase in the incidence of arthroplasty among patients with primary knee OA in Finland, especially in those ages 50–59 years. There was no single explanatory factor behind this finding, although some of the growth might be due to the increased incidence noted in low‐ and intermediate‐volume hospitals.

     

Ex vivo MR microimaging of neuronal damage after kainate-induced status epilepticus in rat: correlation with quantitative histology.

The present study was designed to investigate whether T(2)-weighted signal changes obtained by microimaging of paraformaldehyde-fixed brain correlate with the histologically quantified damage in a model of status epilepticus (SE) induced by kainic acid in the rat. Animals were killed at several time points up to 8 weeks after a single intraperitoneal kainate (KA) injection (9 mg/kg). Perfusion-fixed brains were embedded in gelatin for MR microimaging at 9.4T. After the MRI analysis, the gelatin was removed and the brains were cryoprotected and processed for quantitative histology. Severity of neuronal damage and gliosis were assessed from thionin-stained serial sections. Correlative analysis of microimaging and histology data was done in the hippocampus, amygdala, parietal rhinal cortex (PaRH), piriform cortex (Pir), and entorhinal cortex. The relative signal intensities in T(2)-weighted images correlate with the severity of neuronal damage in the matched histological sections (correlation coefficients of 0.752-0.826). Our data show that MR microimaging ex vivo detects the degree of neuronal damage and its anatomical distribution after KA-induced SE, thus providing a useful tool for detecting the dynamics of progressive neuronal damage after prolonged seizures.     

Ubiquitin C-terminal hydrolase L1 after out-of-hospital cardiac arrest

Background

We studied the prognostic ability of serum ubiquitin C-terminal hydrolase L1 (UCH-L1) after out-of-hospital cardiac arrest (OHCA), compared to that of neuron-specific enolase (NSE).

Methods

In this post-hoc analysis of the FINNRESUSCI study, we measured serum concentrations of UCH-L1 in 249 OHCA patients treated in 21 Finnish intensive care units in 2010–2011. We evaluated the ability of UCH-L1 to predict unfavourable outcome at 12 months (defined as cerebral performance category 3–5) by assessing the area under the receiver operating characteristic curve (AUROC), in comparison with NSE.

Results

The concentrations of UCH-L1 were higher in patients with unfavourable outcome than for those with favourable outcome: median concentration 10.8 ng/mL (interquartile range, 7.5–18.5 ng/mL) versus 7.8 ng/mL (5.9–11.8 ng/mL) at 24 h (p < .001), and 16.2 ng/mL (12.2–27.7 ng/mL) versus 11.5 ng/mL (9.0–17.2 ng/mL) (p < .001) at 48 h after OHCA. For UCH-L1 as a 12-month outcome predictor, the AUROC was 0.66 (95% confidence interval, 0.60–0.73) at 24 h and 0.66 (0.59–0.74) at 48 h. For NSE, the AUROC was 0.66 (0.59–0.73) at 24 h and 0.72 (0.65–0.80) at 48 h. The prognostic ability of UCH-L1 was not different from that of NSE at 24 h (p = .82) and at 48 h (p = .23).

Conclusion

Concentrations of UCH-L1 in serum were higher in patients with unfavourable outcome than in those with favourable outcome. However, the ability of UCH-L1 to predict unfavourable outcome after OHCA was only moderate and not superior to that of NSE.     

Intraepithelial lymphocytes bearing the γ/δ receptor in the oral and jejunal mucosa in patients with dermatitis herpetiformis

Lymphocytes bearing T cell receptor (TcR) γ/δ are increased in the jejunal mucosa of patients with dermatitis herpetiformis (DH) and coeliac disease. In this study, we examined whether increased numbers of γ/δ TcR positive lymphocytes occur in the oral mucosa of patients with DH. Oral and jejunal rnucosal biopsies were taken from 13 newly diagnosed and 13 gluten free diet (GFD)-treated patients with DH. Monoclonal antibodies and avidin-biotin peroxidase method was used for staining, and TcR positive cells were counted from the buccal and jejunal epithelium. Very few γ/δ TcR positive lymphocytes were seen in the buccal epithelium of untreated or GFD-treated DH patients (median 0.4 and 0.3 cells/mm²), whereas α/β TcR positive lymphocytes were frequent in both groups of DH patients (154 and 250 cells/mm²) and healthy controls (135 cells/mm²). The numbers of γ/δ TcR positive intraepithelial lymphocytes were significantly increased in the jejunum of both untreated (43 cells/mm) and GFD-treated (27 cells/mm) DH patients compared to control patients (2.2 cells/mm). The present study did not, therefore, disclose any evidence for active recruitment of γ/δ TcR positive lymphocytes in the oral epithelium, but showed substantial amounts of intraepithelial γ/β TcR positive lymphocytes both in DH patients and healthy controls.