Posterolateral diaphragmatic hernia in adults--acute symptoms, diagnosis and treatment. Case report.

Acute herniation through a posterolateral diaphragmatic defect is rare in adults. Two cases in which such herniation occurred by sudden inversion, a 29-year-old man and a 17-year-old girl, are presented. The symptoms, diagnosis and treatment are discussed.     

Expression of a partially deleted gene of human type II procollagen (COL2A1) in transgenic mice produces a chondrodysplasia.

A minigene version of the human gene for type II procollagen (COL2A1) was prepared that lacked a large central region containing 12 of the 52 exons and therefore 291 of the 1523 codons of the gene. The construct was modeled after sporadic in-frame deletions of collagen genes that cause synthesis of shortened pro alpha chains that associate with normal pro alpha chains and thereby cause degradation of the shortened and normal pro alpha chains through a process called procollagen suicide. The gene construct was used to prepare five lines of transgenic mice expressing the minigene. A large proportion of the mice expressing the minigene developed a phenotype of a chondrodysplasia with dwarfism, short and thick limbs, a short snout, a cranial bulge, a cleft palate, and delayed mineralization of bone. A number of mice died shortly after birth. Microscopic examination of cartilage revealed decreased density and organization of collagen fibrils. In cultured chondrocytes from the transgenic mice, the minigene was expressed as shortened pro alpha 1(II) chains that were disulfide-linked to normal mouse pro alpha 1(II) chains. Therefore, the phenotype is probably explained by depletion of the endogenous mouse type II procollagen through the phenomenon of procollagen suicide.     

Chondrocyte ultrastructure in exercise and experimental osteoarthrosis. A stereologic morphometric study of articular cartilage of young rabbits using transmission electron microscopy

The effects of physical exercise (running) and immobilization (splinting) on chondrocyte ultrastructure were studied in the knee joint articular cartilage of 24 young rabbits. Synthetic activity of the chondrocytes was quantified by measuring the amount of rough endoplasmic reticulum (RER) from electron micrographs using a sterologic point-counting method. Extra loading of the joint by running, or by increased weight-bearing after splinting of the contralateral limb, caused a 20% and 30% increment of RER in the middle and deep zones of the cartilage, respectively, while immobilization decreased the amount of RER by 30% in the superficial zone. Some attempts to repair and regenerate were observed, especially in the deep zone of articular cartilage. Hypertrophy of cells and organelles, and cell replication were considered as signs of reparative processes. The accumulation of fine intracytoplasmic filaments (FIF) in chondrocytes, regarded as a sign of cell degeneration, was reduced in the exercise group. FIF also decreased in the deep zone chondrocytes of the immobilized group, which could be indicative of improved or retained viability of the chondrocytes.     

Importance of the superficial tissue layer for the indentation stiffness of articular cartilage

Indentation testing is a widely used technique for nondestructive mechanical analysis of articular cartilage. Although cartilage shows an inhomogeneous, layered structure with anisotropic mechanical properties, most theoretical indentation models assume material homogeneity and isotropy. In the present study, quantitative polarized light microscopy (PLM) measurements from canine cartilage were utilized to characterize thickness and structure of the superficial, collageneous tissue layer as well as to reveal its relation to experimental indentation measurements. In addition to experimental analyses, a layered, transversely isotropic finite element (FE) model was developed and the effect of superficial (tangential) tissue layer with high elastic modulus in the direction parallel to articular surface on the indentation response was studied. The experimental indentation stiffness was positively correlated with the relative thickness of the superficial cartilage layer. Also the optical retardation, which reflects the degree of parallel organization of collagen fibrils as well as collagen content, was related to indentation stiffness. FE results indicated effective stiffening of articular cartilage under indentation due to high transverse modulus of the superficial layer. The present results suggest that indentation testing is an efficient technique for the characterization of the superficial degeneration of articular cartilage.     

Estimation of genetic risk for type 1 diabetes

The most important gene loci defining risk of type 1 diabetes mellitus (T1DM) are located within the HLA gene region. HLA-DQ molecules are of primary importance but HLA-DR gene products modify the risk conferred by HLA-DQ. The risk associated with an HLA genotype is defined by the particular combination of susceptible and protective alleles. The highest risk is associated with a combination of two different risk haplotypes (7% risk to develop T1DM in Finland) whereas protective genotypes covering 69% of population have a risk of less than 0.2%). The complicated analysis of HLA genotypes is simplified by strong linkage disequilibrium between HLA-DRB1, -DQA1 and -DQB1 loci. In many cases one can deduce the alleles of other loci based on determination of the alleles in one locus. Differences between various populations in the frequency of marker alleles and in the linkages between them has to be taken into account. We have developed PCR based typing methods that utilize blood spot samples, microtiter plate format and lanthanide labeled oligonucleotide probes to define HLA-DQ and -DR alleles relevant for T1DM risk. Typing is run stepwise so that after initial HLA-DQB1 typing only those samples will be further analyzed in which -DQA1 or -DRB1 typing is informative and expected to contribute to the risk estimation. This method has been used to screen more than 50,000 newborn infants in Finland over a time period of 6 years, and it has been able to identify most children who have developed T1D during the follow-up period. The efficiency of the procedure has also been tested in Finnish and Greek populations.     

Fine structure of the carotid body of the midterm human fetus

Summary The human fetal carotid body was studied using both histochemical and electron microscopic methods. The glomus cells of a mid term fetal carotid body evidently contain catecholamines. This was demonstrated both by formaldehyder-induced fluorescence of the cells and by the presence of typical dense-cored vesicles (diameter 1430–3200 Å) in the cytoplasm of the chief cells. The glomus cells were densely innervated and the synapses found on their surface were probably cholinergic in type, containing agranular synaptic vesicles measuring 400–700 Å in diameter with a few dense-cored vesicles measuring 900 to 1300 Å. Synapses were not found in any other cell type within the glomus caroticum. The prominent feature of the glomus cell cytoplasm was the presence of the dense-cored vesicles. The density of the vesicular core varied only slightly from cell to cell. There were no perceptible differences in vesicular size between the different cells. The glomus cells were mostly surrounded by the processes of the sustentacular cells, which usually also surrounded the capillary walls. No glomus cells were ever found in direct contact with the capillary wall. The capillaries were wide and very numerous over the restricted area of the organ. They formed sinusoidal loops, probably anastomosing with each other. Finally, the features of the fine structure are discussed, correlating the present findings with our knowledge about the adult functional carotic body.     

Hemagglutination by BK Virus, a Tentative New Member of the Papovavirus Group

Some characteristics of hemagglutination (HA) by the BK virus, a new candidate for the papovavirus group, have been studied. Hemagglutinin prepared from cell cultures was found to be partially masked by inhibitors which could be dissociated from the virus by incubation at 37 C or by fluorocarbon extraction. Optimal conditions for HA are outlined. In routine tests, 0.5% human erythrocytes were used. The reaction was carried out at pH 7.0 on ice-water slurry. BK hemagglutinin receptors on human erythrocytes were found to be more resistant to neuraminidase than polyoma receptors. By gradient centrifugation analysis, two types of particles were found to be responsible for HA: (i) full, deoxyribonucleic acid-containing particles with a density of 1.325 g/cm(3) and (ii) empty capsids with a density 1.29 g/cm(3). Based on particle counting, one HA unit was calculated to correspond to 3 x 10(6) virus particles.     

Standard sera in solid-phase immunoassays

Solid-phase immunoassay-derived antibody titers are often converted to weight unit concentrations with the aid of standard sera containing known antibody concentrations. Systematic studies justifying this procedure have not yet been published. We therefore investigated the magnitude of errors associated with this conversion. Antibody concentrations of thirteen sera or ascites fluids were determined by quantitative precipitation or equlibrium dialysis, and one was then used as a “standard antibody” for the others in solid-phase radioimmunoassay (SP-RIA) or enzyme-linked immunosorbent (ELISA) assays. Antibody concentrations determined by the conventional solid-phase assay (the “standard serum” has the same specificity as the “sample”) had up to fourfold errors. These errors could be reduced by basing the conversion on the combination of two standard sera instead of one. The possibility was studied of whether the conversion to weight units could be done with the aid of a standard serum directed to a different antigen than the sample antibody. Errors associated with the use of such a heterologous standard were not significantly greater than those found using the conventional conversion. A combination of two reference sera again reduced the errors. The use of such heterologous standard(s), however, requires checking the binding capacity of the antigen coats.     

Physical work capacity in dynamic exercise with differing muscle masses in healthy young and older men

Ten young (aged 23–30 years) and nine older (aged 54–59 years) healthy men with similar estimated limb muscle volumes performed, in random order, three different types of ergometer exercise tests (one-arm cranking, two-arm cranking, and two-leg cycling) up to the maximal level. Values for work load (WL), peak oxygen consumption , peak heart rate (HR), peak ventilation , respiratory gas exchange ratio (R), recovery blood lactate concentration [La^–], and rating of perceived exertion (RPE) were compared between the age-groups in the given exercise modes. No significant age-related differences in WL, peak , peak HR, R, [La^–], or RPE were found in one-arm or two-arm cranking. During one-arm cranking the mean peak was 1.65 (SD 0.26)1 · min^–1 among the young men and 1.63 (SD 0.10)1 · min^–1 among the older men. Corresponding mean peak during two-arm cranking was 2.19 (SD 0.32)1 · min-1 and 2.09 (SD 0.18)1 · min^–1, respectively. During one-arm cranking peak was higher (P < 0.05) among the older men compared to the young men. During two-leg cycling the young men showed higher values in WL (P < 0.001), peak (P < 0.001), and peak HR (P < 0.001). The mean peak was 3.54 (SD 0.24)1 · min^–1 among the young men and 3.02 (SD 0.20)1 · min^–1 among the older men. Corresponding mean peak HR was 182 (SD 5) beats · min^–1 and 170 (SD 8) beats · min^–1, respectively. During two-leg cycling, peak , R, [La^–], and RPE did not differ between the two age-groups. In summary, the older men with similar sizes of estimated arm and leg muscle volumes as the young men had a reduced physical work capacity in two-leg cycling. In one-arm or two-arm cranking, no significant difference in work capacity was found between the age-groups. These results indicate, that in healthy men, age, at least up to the 6th decade of life, is not necessarily associated with a decline in physical work capacity in exercises using relatively small muscle groups, in which the limiting factors are more peripheral than central.