Axial rotation in the lumbar spine and gaping of the zygapophyseal joints

Axial rotation and zygapophyseal joint gaping was studied using 12 human lumbar spines from individuals ranging in age from 14 to 75 years. Using weight and pulley tests and manipulative testing in a torque apparatus, the movement produced by twisting the spine was found not to be pure axial rotation, but rather movement coupled with various combinations of lateral bending and flexion or extension. This motion may not be possible in testing an individual mobile segment. The twisting movements of the spine do not normally produce gaping of the zygapophyseal joints. These joints adapt to the axial rotation by the compliance of their articular cartilages and the movement of fat pads in and out of the joint capsule. Hypermobility appears to be associated with evidence of damage to part of the mobile segment, suggesting that the hypermobility (gaping) at a joint could be due to instability caused by injury.     

The value of a diagnostic setup for full fixed maxillary implant prosthetics.

The concept of prosthesis-directed implant-supported restoration is well accepted. The implementation of this principle for patients requesting full fixed implant-supported maxillary prosthetics has not been thoroughly described. We present a technique for the evaluation and preprosthetic surgical management of patients who are edentulous in the maxilla and wish to have fixed implant-supported crown and bridge prosthetics.     

Autoimmune progesterone dermatitis: absence of contact sensitivity to glucocorticoids, oestrogen and 17-α-OH-progesterone

Autoimmune progesterone dermatitis is a rare condition, characterized by recurrent premenstrual exacerbations of a dermatosis, in which sensitivity to progesterone can be demonstrated. The sensitizing mechanism is unknown. The aim of this study was to test the hypothesis that cross-sensitivity between steroid groups could induce allergy to endogenous progesterone in these patients. 5 patients with autoimmune progesterone dermatitis and 1 with oestrogen-sensitive dermatitis have been patch tested with a corticosteroid series, conjugated oestrogen 1% in petrolatum (pet.), and 17-α-OH-progesterone 2% pet. There were no immediate or delayed reactions at 2 and 4 days to any steroid group. We have therefore been unable to demonstrate steroid cross-sensitivity, or a use for 17-α-OH-progesterone in the investigation of oestrogen - and progesterone-sensitive dermatoses.     

Lupus glomerulonephritis with thrombotic microangiopathy

Well-documented cases of systemic lupus erythematosus (SLE) with thrombotic microangiopathy (TMA) are rare. Renal biopsy in a 25-year-old woman with SLE who was in renal failure demonstrated proliferative lupus glomerulonephritis with arteriolar thrombosis and the arterial intimal changes of TMA. No staining of vessels for immunoglobulins or complement was found by direct immunofluorescence. Fibrillar and flocculent deposits were seen in the widened and rarefied subendothelial space in a small artery and two glomeruli, one of which also contained electron-dense deposits. The vascular findings, which are those of TMA, are distinct from the immune complex vasculopathy of SLE.     

The 'supervirus'? Lessons from IL-4-expressing poxviruses

Members of the Poxviridae family are particularly adept at avoiding the host immune system, encoding a plethora of immunomodulatory proteins that subvert host defense. With their large genome, poxviruses are also useful for studying the effect of exogenous genes on virus-host interactions and immune responses. The insertion of the Th2 cytokine interleukin-4 (IL-4) into several poxviruses significantly increases the efficiency of the recombinant virus as a pathogen by directly inhibiting the development of Th1 immunity, which is crucial for viral clearance. In an age in which the fear of genetically modified weaponized pathogens exists, the understanding of how to make viruses more pathogenic further blurs the distinction between fundamental academic research and bioweapons development. Here, the extent of immune evasion by IL-4-expressing poxviruses will be explored, as will the consequences of this increased pathogenicity on protective immune responses.     

Uterine myomata and outcome of assisted reproduction

The aim of this work was to study the effect of uterine myomata on the implantation rate and outcome in in-vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). Among 406 patients, 51 (12.6%) were found to have uterine corporeal myomata. Twelve patients were excluded from the study as they had large myomata, submucous myomata or intramural myomata encroaching on the cavity. These patients were advised to have myomectomy before being enrolled in the IVF/ICSI programme. The remaining patients (n = 39) were sorted according to the number, site and size of the myomata as assessed by transvaginal sonography. Three patients had more than one myoma. Most of the myomata were subserous (72.7%) and the mean diameter of the myomata was 3.5 +/- 0.9 cm. A control group (n = 367) was chosen with normal uteri and no history of uterine reconstruction surgery. The mean age of myoma patients was 34.7 +/- 3.6 years as compared to 34.0 +/- 4.4 years in the control group. The age, period of infertility, body mass index, duration and number of human menopausal gonadotrophin ampoules needed for stimulation, oestradiol levels, number of oocytes retrieved and the fertilization rate were not significantly different in the myoma patients compared to the control group. Fifteen myoma patients (38.5%) subsequently showed one or more pregnancy sacs on ultrasonography of which three (20%) spontaneously aborted during the first trimester and two (13.3%) had preterm labour, as compared to 123 (33.5%), 19 (15.5%) and nine (7.3%) respectively, among the control group (P = 0.27, 0.33 and 0.21). In conclusion, uterine corporeal myomata, not encroaching on the cavity and <7 cm in mean diameter, do not affect the implantation or miscarriage rates in IVF or ICSI.      

Comparative morphometry of the upper bronchial tree in six mammalian species

The length, diameter, and angle of branching of all airways through the sixth level of branching below the trachea were measured on corrosion casts prepared from the lungs of two animals whose bronchial geometry has not previously been studied, namely the donkey and the rabbit. These measurements and morphometric data for the rat, hamster, dog, and human obtained from other sources were analyzed and compared. The cast prepared from human lungs exhibited an airway geometry that was clearly distinct from that shown by the nonhuman species. The human upper bronchial tree was the most symmetrical with respect to airway diameter and angle of branching. In all species studied, airway length was the most irregular parameter. The reasons for differences in branching geometry are not clearly understood. However, when attempting to determine whether a particular species may be used as a model for man in inhalation toxicology, and in the subsequent interpretation of animal data, an appreciation of differences in airway morphometry is essential.