The sacroiliac part of the iliolumbar ligament

The iliolumbar ligament has been described as the most important ligament for restraining movement at the lumbosacral junction. In addition, it may play an important role in restraining movement in the sacroiliac joints. To help understand its presumed restraining effect, the anatomy of the ligament and its orientation with respect to the sacroiliac joints were studied in 17 cadavers. Specific dissection showed the existence of several distinct parts of the iliolumbar ligament, among which is a sacroiliac part. This sacroiliac part originates on the sacrum and blends with the interosseous sacroiliac ligaments. Together with the ventral part of the iliolumbar ligament it inserts on the medial part of the iliac crest, separate from the interosseous sacroiliac ligaments. Its existence is verified by magnetic resonance imaging and by cryosectioning of the pelvis in the coronal and transverse plane. Fibre direction, length, width, thickness and orientation of the sacroiliac part of the iliolumbar ligament are described. It is mainly oriented in the coronal plane, perpendicular to the sacroiliac joint. The existence of this sacroiliac part of the iliolumbar ligament supports the assumption that the iliolumbar ligament has a direct restraining effect on movement in the sacroiliac joints.     

CD40 engagement modulates the production of matrix metalloproteinases by gingival fibroblasts

Chronic periodontitis is a destructive inflammatory disease linked with unbalanced production between matrix metalloproteinases (MMPs), such as interstitial collagenase (MMP-1) and stromelysin-1 (MMP-3) and their endogenous tissue inhibitors of MMPs (TIMPs). In addition to aberrant MMP-1 and MMP-3 expression, periodontal lesions are characterized by dense infiltrations of activated T lymphocytes which may interact with CD40-expressing gingival fibroblasts in the connective tissue via the CD40L-CD40 pathway. In this study we investigated whether CD40 cross-linking influenced MMP production by gingival fibroblasts. Therefore, we analysed the CD40L-induced MMP production by these fibroblasts in the presence of cytokines that are increased in periodontal lesions, such as IL-1β, tumour necrosis factor-alpha (TNF-α) and interferon-gamma (IFN-γ). We show that CD40 ligation on gingival fibroblasts resulted in a decrease of their MMP-1 and MMP-3 production, while MMP-2 and TIMP-1 production were unaffected as determined by Western blot. This down-regulatory effect of CD40 engagement on MMP-1 and MMP-3 production by gingival fibroblasts was also present when MMP production was up-regulated by IL-1β and TNF-α or down-regulated by IFN-γ. These results suggest that CD40 ligation on gingival fibroblasts leads to a restraining of MMP-1 and MMP-3 production by gingival fibroblasts and thereby may be an important mechanism in the retardation of further periodontal tissue damage.     

Relation of fetal blood gases and data from computer-assisted analysis of fetal heart rate patterns in small for gestation fetuses

Summary. Fetal heart rate (FHR) monitoring and computer-assisted analysis were performed immediately before cordocentesis in 25 severely small-for-gestational age fetuses. There were significant associations between FHR variation and both umbilical vein blood Po₂ (  r= 0–66  ) and pH (  r=0.69  ). However, the wide scatter of values around the regression lines prevented accurate prediction of fetal blood gases from FHR patterns. Nevertheless, FHR variation <20 ms was always associated with severe fetal hypoxaemia and acidaemia.