New insights into the morphogenesis of the gubernaculum testis and the inguinal canal

There is no consensus about the role of the gubernaculum testis (GT). Nineteen human embryos (Carnegie stages 15–23), 36 fetuses (9 weeks to term), and eight neonates were examined. All the embryos and 25 fetuses (from weeks 9–16) were processed for paraffin wax histology and serially sectioned at 10 µm thickness. The remaining 11 fetuses and the eight neonates were fresh specimens that were dissected under a surgical microscope. The GT appeared during the embryonic period (stages 17–23) with a horseshoe‐shaped mesenchyme condensation of the superior concavity, which was observed in four different topographical regions sequentially through development. The GT was not attached at either of its ends in any of the specimens, not to the gonad or in the scrotal sac. The inguinal canal differentiates around the inguinal portion of the GT during the late embryonic period. After stage 21, the GT appears enveloped by an evagination of the peritoneal cavity. It has few striate muscular fibers and vessels. Although the GT does not appear to have the role traditionally attributed to it, it is still an essential structure and indirectly facilitates the descent of the testes. It contributes to the formation of the inguinal canal and then forges the pathway that the testes will subsequently take through the inguinal canal as they migrate from the abdominal cavity into the scrotal sac. Clin. Anat. 30:599–607, 2017. © 2017 Wiley Periodicals, Inc.     

Plasma Potassium and Phosphate Concentrations—Influence by Adrenaline Infusion, β-blockade and Physical Exercise

ABSTRACT. Ljunghall S, Joborn H, Rastad J, Åkerström G (Departments of Internal Medicine, and Surgery, University Hospital, Uppsala, Sweden). Plasma potassium and phosphate concentrations—influence by adrenaline infusion, β-blockade and physical exercise. Acta Med Scand 1987; 221:83–93. Infusion of adrenaline into healthy male subjects reduced the plasma concentrations of both potassium and phosphate to a similar extent, in a dose-dependent manner, an effect which was prevented by the administration of propranolol. Ergometer bicycling until exhaustion, which caused marked accumulation of lactic acid in the blood and reduction of pH, induced great elevations of both plasma potassium and phosphate with close relationships between the raised plasma concentrations and the reduction in pH, also during β-blockade. However, longer-term aerobic exercise, without acidosis, also caused some rise of the potassium and phosphate concentrations. During recovery from anaerobic, but not from aerobic, exercise there was a rapid decrease of the plasma potassium levels while the phosphate values normalized gradually together with pH. From measurements of the ion concentrations both in the femoral effluent of one leg, which carried out maximal isokinetic work, and in the opposite antecubital vein it could be calculated that there was for potassium, but not for phosphate, a post-exercise uptake both in the exercised muscle and in the entire organism, indicating the participation of systemic factors.     

Clodronate Treatment in Patients with Malignancy-associated Hypercalcemia

ABSTRACT. Rastad J, Benson L, Johansson H, Knuutila M, Pettersson B, Wallfelt C, Åkerström G, Ljunghall S (Departments of Surgery and Internal Medicine, University Hospital, Uppsala, Sweden). Clodronate treatment in patients with malignancy-associated hypercalcemia. Acta Med Scand 1987; 221:489–94. The possibility of reducing symptomatic hypercalcemia and of maintaining total serum calcium concentrations <2.8 mmol/1 with clodronate (dichloromethylene bisphosphonate) was evaluated in 28 patients with various types of malignant tumors. Four episodes of hypercal-cemic crisis with mean serum calcium concentrations of 4.43 mmol/1 were controlled within 4–6 days of intravenous clodronate (4 mg/kg BW/day). This was accompanied by a moderate increase in serum creatinine values which, however, returned to pretreatment levels after therapy withdrawal in all but one case. Oral clodronate successfully reduced a mean serum calcium concentration of 3.16 mmol/1 in 22 out of 25 patients after 3–12 days (800–3 200 mg/ day). After reversal of the hypercalcemias oral clodronate controlled the serum calcium concentration for up to 42 weeks in six out of 15 patients After discontinuation of initial therapy five of seven recurrent hypercalcemias were successfully treated with oral or intravenous clodronate. Hypocalcemia and subjective side-effects were uncommon. It is concluded that clodronate is a valuable clinical tool in the management of patients with malignancy-associated hypercalcemia.     

The acetabular point: a morphological and ontogenetic study

The acetabular point was analysed by studying human pelvic bones from 326 individuals ranging from newborns to age 97 y. The bones were categorised into 3 groups according to the degree of fusion for the 3 elements of the pelvis: nonfused (59), semifused (5) and fused (262). The acetabular point in immature pelvic bones is clearly represented by the point of the fusion lines for each bony element at the level of the acetabular fossa. In adult pelvic bones the acetabular fossa has an irregular clover-leaf shape, the superior lobe being smaller than the anterior and posterior lobes. Cross-sectional analysis of acetabular morphology suggested that the acetabular point in adult pelvic bones is always represented by the indentation between the superior and the anterior lobes of the acetabular fossa.     

Influence of Different Conditioning Methods on Force and Fatigue Resistance in Chronically Stimulated Skeletal Muscles

A study was undertaken to compare different conditioning methods for the transformation of latissimus dorsi muscle into a fatigue resistant one for application in circulatory assist. In ten sheep four electrodes were sutured to the epineurium of the left thoracodorsal nerve for indirect electrical stimulation of the latissimus dorsi muscle. In six sheep a "carousel stimulation, " a special multichannel stimulation, in combination with a recently developed conditioning protocol was used for muscle conditioning ( multichannel method ). In four sheep, a conventional stimulation protocol using single channel stimulation was applied for transformation of the muscle (single channel method). The final experiments were carried out when fatigue resistance was obtained. The maximum tetanic forces at different preloads were determined and fatigue resistance was tested during 20 minutes of continuous stimulation. Both conditioning patterns led to fatigue-free chronic stimulation. Muscles conditioned by multichannel stimulation exhibited between 20% and 33% less force than the contralateral unconditioned muscles, whereas in the single channel group this loss was between 32% and 43%. Thus, the multichannel method revealed relatively superior in preserving muscle force for chronic stimulation.     

Muscle Water and Electrolytes in Patients Undergoing Continuous Ambulatory Peritoneal Dialysis

ABSTRACT. Muscle water and electrolytes were determined in percutaneous muscle biopsy material from m. quadriceps femoris in 33 uremic patients undergoing continuous ambulatory peritoneal dialysis (CAPD) for 1–38 months, and in 34 normal subjects. The patients showed increased muscle contents of water, sodium, and chloride relative to fat-free solids (FFS); both intra- and extracellular water contents were increased. The total water content was inversely correlated with the duration of CAPD. The muscle potassium content was increased, both relative to FFS and to magnesium, whereas the intracellular potassium concentration was normal. Despite hypermagnesemia, the muscle content of magnesium was normal and the intracellular concentration was even slightly decreased due to the increase in intracellular water. We conclude that muscle water and electrolyte status is abnormal in CAPD patients, but the alterations appear to be less marked than in uremic patients undergoing other forms of therapy.