Comment on a proposed draft protocol for the European Convention on Biomedicine relating to research on the human embryo and fetus.

Judge Christian Byk renders service to the Steering Committee on Bioethics of the Council of Europe (CDBI) by proposing a draft of the protocol destined to fill in a gap in international law on the status of the human embryo. This proposal, printed in a previous issue of the Journal of Medical Ethics deserves nevertheless to be questioned on important points. Is Christian Byk proposing to legalise research on human embryos not only in vitro but also in utero?     

Local tissue properties in bone healing: Influence of size and stability of the osteotomy gap

To characterize the site-specific mechanical and histological properties in fracture repair and to relate these properties to the initial mechanical situation, an experimental fracture model was used in the metatarsus of 42 sheep. the mechanical situation of a transverse osteotomy was described by three gap sizes (1,2, or 6 mm) and two amounts of strain (7 or 31 %). An external fixator that allowed a defined axial movement provided control of these settings. Nine weeks following surgery, the healing area was dissected and tensile and compressive properties were measured in subregions of the fracture gap and the periosteal callus. The central, sagittal section was used for quantitative histology. We found the quality of the tissue along the osteotomy line to be most important for regaining mechanical stability. Increasing the size of osteotomy gaps resulted in poorer mechanical and histological qualities, and the repair process was less complete. Interfragmentary strain did not significantly influence the repair process. The smaller strain levels had already stimulated the secondary repair process, and this stimulatory effect could not be further enhanced by increasing the amount of strain. Our finding that large gaps between bone segments were not as well healed as were smaller gaps suggests that it is advantageous to avoid large gaps in fracture treatment.     

Microleakage of Class 2 glass-ionomer-silver restorations in primary molars.

The aims of this study were to assess microleakage at the cervical margins of class 2 "sandwich" restorations placed with two glass-ionomer-silver cements in primary molars, to compare the quality of the occlusal margins of these restorations to those prepared with Miracle Mix and Ketac Silver, and to assess by scanning electron microscopy (SEM) the marginal micromorphology of those restorations. Fifty-two class 2 restorations were prepared in extracted primary molars and were restored as follows: 1) Ketac Silver + Estilux Posterior (sandwich), 2) Miracle Mix + Estilux Posterior (sandwich), 3) Ketac Silver only, and 4) Miracle Mix only. No or minimal leakage was evident in most of the occlusal margins, whereas severe leakage was observed in almost 70% of the cervical margins of the Ketac Silver groups. Scanning electron microscopy evaluation demonstrated good adaptation at the buccal and lingual margins of all the restorations. Sixty-seven percent of the Miracle Mix restorations had no defects at the cervical margins, as opposed to only 17% of those with Ketac Silver.     

Brain tissue heterotopia in the nasopharynx. Contribution of MRI to assessment of extension.

The authors report two cases of brain tissue heterotopia in the nasopharynx, without other malformations and, in one of the cases, with a persistent craniopharyngeal canal opening onto the heterotopia. This exceptional malformation is very similar to brain heterotopia in the nose, or "nasal glioma", which is more frequent and less diversified at histology. The malformation is revealed by obstruction of the pharynx with respiratory distress immediately after birth or during the first weeks of life. Total surgical excision provides cure without sequelae. The diagnosis is based on histology. MRI is essential to the diagnostic and pretherapeutic evaluation, notably to avoid missing an ectopic hypophysis, but it is insufficient to diagnose a sphenoidal meningoencephalocele.     

Delayed and atypical D-glyceraldehyde-induced insulin secretion from the perfused duodenum pancreas of chicken

Insulin release by the isolated-perfused pancreas of 5-8 week-old chickens was studied in response to graded concentrations of D-glyceraldehyde (D-GA) (5-20 mM). D-GA was perfused for 30 min in the absence or in the presence of glucose concentrations (2.8 or 14 mM) which do not evoke insulin release alone. D-GA alone or in combination with glucose does not cause a biphasic insulin release. As compared to rodents the release is reduced and delayed (at least 16 min) and requires higher D-GA concentrations which reveals the insensitivity of the chicken pancreas to D-GA. In the absence of glucose, the release is higher at 15 mM D-GA. Glucose (2.8 or 14 mM) sensitized the pancreas to D-GA by eliciting earlier and higher insulin response but never restored an immediate and biphasic secretory response to D-GA. Glucose amplified the response to low D-GA levels (5 and 10 mM) and inhibited the response to higher concentrations (15 and 20 mM). A transient insulin rise ("off-response") related to the D-GA concentration was observed after withdrawal of D-GA either in the absence or in the presence of glucose. Therefore, in addition to glucose, the chicken pancreas is relatively insensitive to D-GA suggesting that the mechanism leading to insulin release in response to nutrient metabolism is different in chickens as compared to that in mammals.     

Neutrophil-rich Ki-1-positive anaplastic large cell lymphoma: a study by fine-needle aspiration biopsy

Fine-needle aspiration biopsy (FNAB) is an accurate, cost-effective method of evaluating lymphomas. The neutrophil-rich variant of anaplastic large cell lymphoma (NR-ALCL) is a rare non-Hodgkin lymphoma. To our knowledge, we present thefirst study of NR-ALCL by FNAB cytology. Histologic confirmation was available for both patients. Both cases were positive for Ki-1 (CD-30) and were either T-cell or null-cell phenotype. FNAB specimens were highly cellular with a single-cell pattern composed of pleomorphic tumor cells, "hallmark" tumor cells, and a background rich in neutrophils that occasionally obscured tumor cells. Diagnosis on FNAB is difficult owing to the rarity of this tumor, its resemblance to Hodgkin lymphoma and other non-Hodgkin lymphomas that express CD30, its similarity to an infectious process, and its occasional confusion with metastatic carcinoma and melanoma. Reproducible cytologic features usually are present, and the diagnosis can be made conclusively by FNAB in conjunction with ancillary studies.