Rupture of the extensor pollicis longus tendon: a study of aetiological factors.

Although rupture of the extensor pollicis longus (EPL) tendon is a well-known complication of distal radial fractures, a number of patients rupture the EPL because of other conditions. We have retrospectively studied the aetiology of 27 ruptures of the EPL in 26 consecutive patients. Of 19 patients with injured wrists 12 had distal radial fractures, five had blunt trauma, and two had stab wounds that resulted in rupture. In the radial fractures operated on, the EPL rupture was caused by chafing against a dorsal plate (n = 2) or wear against the pins of an external fixator (n = 2). Six patients were taking steroids for systemic diseases and in two cases a local steroid injection was given just before the rupture. We conclude that previous injury is the most common cause of rupture of the EPL. but that rheumatoid arthritis or local or systemic steroids, or both, are also important aetiological factors. Seven patients had an iatrogenic cause for their rupture.     

An Assay for Mannan-Binding Lectin-Associated Serine Protease 3, MASP-3

In analogy to DNA microarrays, protein microarrays offer a new distinct possibility to perform sensitive high-throughput global proteome analysis. However, the development of the protein microarray technology will place high demands upon the design of both probes and solid supports. The analysis of thousands of heterogeneous proteins on a single microarray requires the use of uniform probes, such as antibodies, directly designed for protein microarray applications. We have recently generated a human recombinant single-chain Fv antibody library, genetically constructed around one framework, the nCoDeR-library, containing 2 × 1010 clones. Single framework antibody fragments (sinFabs) selected from this library were successfully applied as probes for microarrays providing sensitive detection in the 600 attomol (mass spectrometry) and the 300 zeptomole range (fluorescence). However, the choice of framework is critical. We have shown that the selected nCoDeR framework displayed excellent functional on-chip stability and arrayed dehydrated probes retained their activity for several months. Furthermore, we have addressed the issues of biocompatibility of the solid support and immobilization strategies for our microarray setup. An in-house-designed substrate, macroporous silicon coated with nitrocellulose (MAP3-NC7), displayed properties equal to, or better than, those of five commercially available supports used as reference surfaces. We have also evaluated different coupling strategies, such as adsorption, covalent coupling, diffusion and affinity coupling. Using a novel affinity tag, the double-(his)6-tag, we increased the binding efficiency of sinFab-molecules to Ni2⁺-coated solid supports, thereby allowing nonpurified probes to be directly applied.     

The effect of various thermal processes on the glycemic response to whole grain wheat products in humans and rats

The effects of different thermal processes used to produce ready-to-eat cereals on the glycemic response to whole grain wheat were investigated in rats. The metabolic response to drum dried flour, which constitutes the major component in instant gruel and porridge, was also studied in healthy human subjects. Boiled flour was used for comparison. The degree of starch gelatinization and rate of starch hydrolysis in vitro were also measured. Incompletely gelatinized steam flaked and dry autoclaved products were digested more slowly in vitro and elicited lower glucose responses in rats compared with completely gelatinized drum dried, extrusion cooked or boiled samples. The initial glycemic response in rats was closely related to the rate of starch hydrolysis in the pepsin/alpha-amylase assay (r = 0.91, P less than 0.04). When pepsin was omitted, no significant correlation was obtained. The peak glucose, insulin and C-peptide responses in humans after breakfast meals of porridge prepared from drum dried flour and from boiled flour were similar, whereas the rate of depression of the glucose curve was more rapid after consuming drum dried porridge. It is concluded that the glycemic response to wheat products is affected by the processing conditions used. The more severe the processing conditions, the more rapid the digestion of starch.     

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Thorakale Strahlentherapie

Zusammenfassung Beim kleinzelligen Lungenkarzinom muss die Dosisintensität der zytotoxischen Behandlungsmodalitäten als wichtige therapeutische Größe angesehen werden. Dies gilt sowohl für die Chemo- als auch die Strahlentherapie in ihrer Kobination. Die Mehrheit der verfügbaren Evidenz deutet an, dass der frühe Einsatz der thorakalen Strahlentherapie, simultan mit einer platinbasierten Zweitgenerationschemotherapie, einen moderaten therapeutischen Vorteil bei Patienten im UICC-Stadium I–III bietet.     

New aspects of the etiology of tendon rupture

Summary Native collagen fibers were exposed to different dynamic loads to simulate damage to tendons and ligaments relevant clinically and for sports medicine. The results suggest that the rupture of a tendon is caused at the submicroscopic fibrillar level. Not only slow or very fast elongation, but also very fast unloading of stretched fibers seems to be responsible for disseminated damage, which reduces the stability of a fiber. This damage is induced by intrafibrillar sliding processes, which occur only a few seconds before macroscopic slippage takes place. The significance of these events for the beginning and progress of repair in vivo is discussed. The conclusions are supported by simultaneous mechanical and radiological measurements, as well as by light- and electron-microscopic results.

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Zusammenfassung Zur Simulierung klinisch bzw. sportmedizinisch relevanter Schäden an Sehnen und Bändern wurden native Kollagenfasern unterschiedlichen dynamischen Belastungen ausgesetzt. Die erzielten Ergebnisse sprechen dafür, die Ursachen einer Sehnenruptur im submikroskopischen fibrillären Bereich zu suchen. Sowohl eine langsame oder ruckartige Dehnung als auch eine ruckartige Entlastung zugbelasteter Fasern scheinen für das Auftreten disseminierter, die Faserstabilität reduzierender Gefügestörungen verantwortlich zu sein. Diese Gefügestörungen werden durch intrafibrilläre Gleitvorgänge eingeleitet, die an den noch voll belastbaren Fasern nur wenige Sekunden vor dem Einsetzen eines makroskopischen Faserfließens auftreten. Die Bedeutung dieser Ereignisse für den Beginn und Verlauf einer in vivo stattfindenden Reparationsphase wird erörtert. Die Aussagen werden gestützt durch simultane mechanische und röntgenographische Messungen sowie durch makroskopische, licht- und elektronenmikroskopische Befunde.