An Electron Microscopic Study on the Process of Acid Demineralization of Cortical Bone

Demineralization has been shown to foster osteoinductive properties of cortical bone grafts, yet little is known about the process of demineralization and how to control it. The purpose of this study was to investigate the process of cortical bone demineralization by using scanning electron microscopy to evaluate how hydrochloric acid demineralizes cortical bone. Results showed that in the demineralization of diaphyseal cortical bone specimens using hydrochloric acid, a uniformly thick circumferential band of demineralized bone matrix surrounds an inner undecalcified bone core as the process of demineralization occurs. The interface between the demineralized and mineralized section of the bone specimens was extremely sharp. This interface between demineralized and undemineralized bone was noted to advance as a reaction front with increasing demineralization which resulted in continuous shrinkage of the inner cortical bone core. This study suggests that cortical bone demineralization can be best described using an advancing reaction front theory, and this explanation can be used for implementation of the concept of controlled demineralization. Received: 19 December 1996 / Accepted: 25 April 1997     

Cholecystokinin antagonist and lipid intake as a function of caloric density and familiarity.

The effect of treatment with the cholecystokinin antagonist L364,718 on intake of different dilutions of corn oil emulsion was tested under two levels of familiarity with the oil emulsion. No increase in intake was observed. To see if the CCK antagonist was effective under our conditions, exogenous CCK was administered under the same conditions. A complete suppression of the large reduction produced by CCK on intake was found.     

In vitro stimulation of antibody formation by peritoneal cells: III. Effect of active immunization on the subsequent in vitro performance of peritoneal and spleen cells

Male CBA mice were given a single intraperitoneal injection of sheep red blood cells (SRBC) or horse red blood cells (HRBC). They were killed at intervals of 1–10 days thereafter, and micro-cultures of spleen cells or peritoneal cells (PC) were prepared. These consisted of a thin film of tissue culture medium containing carboxymethyl cellulose (CMC), mouse lymphoid cells, guinea-pig complement and either SRBC or HRBC, held at 37° under liquid paraffin. Cultures were read repeatedly for appearance of haemolytic plaques.

PC from SRBC-immunized mice showed an altered reactivity on SRBC monolayer cultures. The peak plaque count achieved in vitro fell progressively for 4 days after immunization, and then returned to normal by day 7. The actinomycin D resistant component of the PC response rose rapidly; at 1 day after immunization it was equal to the total response. Over the next 3 days after immunization it fell again to normal levels. The results suggested that the in vivo injection sets in train events locally in the peritoneal cavity which resembled those following in vitro culture of normal PC in SRBC monolayers. The effects were immunologically specific as only marginal changes followed the injection of HRBC.

Spleen cells from SRBC-immunized mice, when cultured in SRBC monolayers, yielded many cells capable of giving plaques after 5–60 minutes incubation, as expected. These were deemed to be cells forming antibody at the moment of killing of the animal. In addition, such cultures developed new plaques over the subsequent 23 hours in culture. These were produced by cells not initially forming antibody which switched into antibody secretion at some time during culture. At early time points after immunization, this second type of cell was much more numerous than the first type. The switch from non-secretor status could occur in the presence of a high concentration of actinomycin D. Operationally these non-secretors in immunized spleens resembled an important fraction of PC from unimmunized retired breeder mice. The progressive conversion of non-secretor cells into secretors, if it occurs in vivo, would have a major influence on the kinetics of appearance of PFC in a spleen after immunization.

While spleen cells from mice immunized with HRBC performed on HRBC monolayers much as described above, PC from HRBC-immunized mice could not be induced to cause significant lysis in HRBC monolayers. The same was true of PC from mice chronically fed with HRBC. In fact, no method has yet been found to persuade PC to produce lytic plaques active against erythrocytes other than SRBC.

     

Induction of biologically active antineutrophil cytoplasmic antibodies by immunization with human apoptotic polymorphonuclear leukocytes

Translocation of intracellular components to the cell surface during the priming or apoptosis of polymorphonuclear leukocytes (PMN) is an important mechanism for interaction of antineutrophil cytoplasmic antibodies (ANCA) with these antigens. To test the capacity of apoptotic PMN to trigger production of ANCA, six groups of mice were immunized with either live or apoptotic lymphocytes, or with live, apoptotic, formalin-fixed, or lysed PMN. Mice immunized with both live and apoptotic neutrophils developed high titers of antibodies which gave a granular cytoplasmic immunofluorescent pattern. These antibodies were specific for lactoferrin and myeloperoxidase. Following a second intravenous infusion of apoptotic PMNs, mice developed anti-PR3 antibodies. Vasculitis lesions were not found in mice which developed ANCA. The ANCA-containing IgG fraction induced superoxide production by human PMNs. These results support the hypothesis that neutrophil-specific antigens presented on the cell membranes of apoptotic PMN may induce ANCA in the proper conditions.     

Immunofluorescent studies of the endometrial arteries in the first trimester of pregnancy

Endometrial spiral arteries from curetted endometrium of 110 first-trimester pregnancies were studied by immunofluorescent (IF) technics using antibodies against human G, M, and A immunoglobulins, C3, C4, and fibrinogen. Heavy deposition of C3 in the arterial walls was found in 16 (14.6%) cases. Immunoglobulins, C4, and fibrinogen were found in only a few cases, and their staining was weak and not considered in this study. There was also a statistically significant (P less than 0.01) higher deposition of C3 in arterial walls of primipara (14 of 52), as compared to multipara (2 of 58). The possible mechanisms of C3 deposition and the importance of the higher incidence of this deposition in primipara are discussed in relation to suggested immunologic pathogenetic alterations in preeclampsia.     

Parametric assessment of myocardial perfusion during interventional cardiac catheterization by means of X-ray densitometry-short-and long-term results

Summary X-ray densitometric evaluation of digital subtraction angiocardiograms allows an assessment of myocardial perfusion by means of the parameter MEAN RISE TIME (MRT), defined as the time from the onset of local myocardial contrast medium opacification to the point of maximum opacification. Best results are obtained when the response of that parameter is compared before and after stimulation of coronary flow by papaverine. A prolongation of this parameter, especially after papaverine, was indicative of an impairment of myocardial perfusion, when compared to the results obtained by TL-201 scintigraphy.In 50 patients with single vessel coronary artery disease the results of MRT pre and post papaverine before and after coronary angioplasty, as well as after 6 months were evaluated for 204 post-stenotic regions-of-interest. Before angioplasty papaverine induced a significant prolongation of post-stenotic MRT (2.3s ± 0.9s vs. 3.1s ± 0.8s; p<0.01), while after successful angioplasty post-stenotic MRT was measured significantly shorter after stimulation of coronary flow (2.6s ± 1.0s vs. 1.9s ± 0.9s; p<0.01). This indicated an improvement in myocardial perfusion. Nevertheless, 16/50 patients still presented pathological results of post-stenotic MRT after papaverine, although angioplasty was regarded successful. These patients presented a markedly higher rate of restenosis (14/16 patients after 6 months), a higher rate of dissections at the dilatation site and a higher rate of dilated vessels, supplying myocardial areas after a Q-wave myocardial infarction.Thus, these results demonstrate the additional information about the short-and long-term outcome of an angioplasty procedure by densitometric myocardial perfusion analysis.     

"Stockless" cost reduction in the operating room

St. Paul-Ramsey Medical Center in St. Paul, MN became one of the first hospitals in the United States to initiate a "stockless" par level inventory system. Successes with stockless led the hospital to look at implementing it in the OR to achieve a reduction of expense to revenue. Materiel Management and Surgical Services discussed a number of issues relevant to implementing a stockless program, including product flow, accuracy and cost of case carts and preference cards, item pricing, committed usage of items brought into the system and establishment of a steering committee. Specific OR issues and practices required evaluation and adjustment, such as the routine use of emergency direct ordering. Information systems support was brought in and a products committee established to do education and oversee the program. Savings for 1993-94 were $185,146.