Biological and physical properties of autogenous vascularized fibular grafts in dogs

The biological and biomechanical properties of normal fibulae, fibulae that had had a sham operation, and both vascularized and non-vascularized autogenous grafts were studied in dogs at three months after the operation. The study was designed to quantify and correlate changes in these properties in orthotopic, stably fixed, weight-bearing grafts and to provide a baseline for additional studies of allografts. The grafts were eight centimeters long and internally fixed. The mechanical properties of the grafts were studied by torsional testing. Metabolic turnover of the grafts was evaluated by preoperative labeling of the dogs with 3H-tetracycline for resorption of bone mineral and with 3H-proline for turnover of collagen. Cortical bone area and porosity were measured. Postoperative formation of bone was evaluated by sequential labeling with fluorochrome. The vascularized grafts resembled the fibulae that had had a sham operation and those that had not had an operation with regard to the total number of osteons and the remodeling process, as measured both morphometrically and metabolically. The vascularized grafts were stronger and stiffer than the non-vascularized grafts and were not different from the bones that had had a sham operation. In contrast, the non-vascularized grafts were smaller, weaker, less stiff, and more porotic, had fewer osteons, and demonstrated increased turnover and resorption compared with the vascularized grafts, the bones that had had a sham operation, and the bones that had not been operated on.     

Outcome factors in surgically treated patients for cervical spondylotic myelopathy

Context/Objective: To investigate prospectively preoperative parameters that might be related to the outcome of surgically treated patients for cervical spondylotic myelopathy (CSM).

Design: Prospective study.

Setting: Single Center in Ioannina, Greece.

Participants: Thirty-six patients were included in the study. There were 21 males and 15 females, mean age 50.8 years, range 39–70 years. The mean BMI was 27.3.

Outcome measures: From each patient, we recorded age, sex, BMI, symptoms, duration of symptoms, comorbidities, lifestyle, myelopathy grade based on MRI and levels of compression. All patients completed the modified JOA (mJOA) and NPE questionnaires preoperatively and at 1, 3, 12 months and 5-years postoperatively.

Results: The mean mJOA score significant improved from 10.8?±?1.9 points preoperatively to 16.6?±?2.2 points at 12 months postoperatively. The mean mJOA score at 5-years postoperatively was 15.5?±?3 points. The difference was still highly significant. The mean NPE score significant improved from 59.8?±?12.2 points preoperatively to 28.2?±?8.5 points at 1 month, to 35.8?±?8.1 points at 3 month and to 28.2?±?8.8 points at 12 months postoperatively. Younger patients had significant higher baseline mJOA scores and significant higher mJOA scores 5-year postoperatively. No correlation was found between sex, BMI, symptom duration, baseline mJOA or myelopathy grade and outcome at 12 months or 5-year postoperatively.

Conclusion: Age was highly predictive factor of outcome for patients undergoing surgical treatment of CSM.     

The effects of nickel and chromium on human keratinocytes: differences in viability, cell associated metal and IL-1alpha release.

This study was carried out to assess the effects of chromium and nickel upon isolated keratinocytes as an in vitro model of human skin. Keratinocytes were isolated from healthy volunteer skin samples of unknown metal sensitivity (n=10) and were compared with cells from patient biopsies of known metal sensitivity (n=7). Cells were dosed with a concentration range of nickel and chromium (0-10,000 microM) and cellular mitochondrial activity, viability, metal uptake and cytokine release were measured. Responses of primary versus passaged keratinocytes were also compared. Toxicity data from primary and passaged keratinocytes was statistically analysed by the non-linear Hill Plot model. Results showed that hexavalent chromium was significantly more cytotoxic, associated more with keratinocytes and induced a dose dependant release of IL-1alpha compared to nickel. Significant differences were observed between primary and passaged keratinocytes with regard to the toxicity of chromium and nickel and variation of response. No differences were observed in the cytotoxicity or cytokine release induced by chromium or nickel for the known sensitised biopsy patient samples (n=4) compared to patch test negative controls (n=3). The results from this study suggest human keratinocytes in vitro respond very differently to chromium and nickel.     

Intracellular and plasma cytokine profile in neonates born to non-atopic parents: the impact of breast feeding

The aim of this study was to profile the changes in intracellular and plasma cytokines during the neonatal period and evaluate the impact of breast feeding on these parameters. For this purpose, we measured the interleukin (IL)-2 and IL-4 producing CD3+/CD69+ T-cells using flow cytometry and plasma concentrations of interferon (IFN)-gamma and IL-4 using ELISA, in 122 healthy term neonates, aged 6–12 h, born to non-atopic parents, and 25 healthy children aged 1–12 years. A total of 42/122 neonates exclusively breast-fed (BF) and 39/122 formula fed (FF) were studied again on the 30th day of life for the above parameters. Finally, a clinical evaluation for the presence of atopic disease was conducted at 2 years of age. We found that at birth, the percentage of CD3+/CD69+/IL-4+ T-cells (median = 15.8%, range = 4.4%–49%) and plasma concentrations of IL-4 (median = 0.22 pg/ml, range = 0.18–0.25 pg/ml) were significantly higher (P<0.0001) compared to those of children (median = 1.6%, range = 0.16%–2.7% for CD3+/CD69+/IL-4+ and median = 0.17 pg/ml, range = 0.13–0.26 pg/ml for IL-4), whereas plasma concentrations of IFN-gamma were significantly lower in neonates (median = 0.42 pg/ml, range = 0.3–1.5 pg/ml) than in children (median = 1.2 pg/ml, range = 0.3–2.6 pg/ml, P<0.0001). During the neonatal period, only the CD3+/CD69+/IL-4+ T-cells increased significantly in both BF and FF groups. Comparison between BF and FF groups revealed no significant difference in any of the parameters measured. Moreover, no difference in the development of atopy during the first 2 years of life was found between BF and FF infants. Conclusion: our findings demonstrate that during the entire neonatal period type 2 immunity dominates, regardless of the mode of feeding, whereas type 1 immunity dominates during childhood. Moreover, in the absence of family history of atopy, the mode of feeding per se does not play a crucial role in the development of atopy within the first 2 years of life.Abbreviations BF breast-fed - BFA brefeldin A - FITC fluorescein isothiocyanate - FF Formula-fed - IFN interferon - IL interleukin - MoAbs monoclonal antibodies - PBS-BSA phosphate buffered saline bovine serum albumin - PE-Cy 5 phycoerythrin-cyanin 5 - PMA phorbol 12-myristate 13-acetate - Tc T-cytotoxic - Th T-helper     

Rare manifestations of sirenomelia syndrome: a report of five cases

Five cases of sirenomelia presented with rare manifestations are discussed. Three neonates were born alive and died within 2 to 12 hours after birth. One case was the offspring of a triple in vitro fertilization pregnancy with history of early intrauterine death of one of the triplets. The main features included fusion of lower extremities (five of five), renal agenesis (three of five), polycystic renal dysplasia (two of five), anal atresia with large bowel hypoplasia (three of five), pulmonary hypoplasia (four of five), and single umbilical artery (five of five). Other features that have only rarely been associated with sirenomelia included concurrence of congenital heart disease and neuroblastoma, gallbladder agenesis, and upper extremity defects.     

1-(3,5-difluoro-4-hydroxyphenyl)-1H-pyrrol-3-yl]phenylmethanone as a bioisostere of a carboxylic acid aldose reductase inhibitor

[1-(3,5-Difluoro-4-hydroxyphenyl)-1H-pyrrol-3-yl]phenylmethanone (6) was synthesized as a putative bioisostere of the known aldose reductase (AR) inhibitor (3-benzoylpyrrol-1-yl)acetic acid (I). It was found that 6 is approximately 5 times more potent as an in vitro inhibitor of AR than I, with an IC(50) value in the submicromolar range. Furthermore, 6 showed considerable activity in an in vitro experimental glycation model of diabetes mellitus. Our results support the notion that 6 might become a useful lead structure.     

Comparison of whole calvarial bones and long bones during early growth in rats. Histology and collagen composition.

The distribution of ossified collagen (bone) and uncalcified collagen (fibrous tissue and cartilage) was compared histologically for rat and dog calvaria at birth. The relative amount of bone and uncalcified collagen was quantitated morphologically for rat calvaria during the first four weeks of rapid growth. Whereas dog calvaria are essentially ossified at birth, rat calvaria at birth consist mostly of fibrous tissue but rapidly become ossified with growth. Bacterial collagenase was used to separate uncalcified collagen from calcified collagen of whole membranous bones (frontal and parietal) and long bones (femur and humerus) at birth from man, monkey, dog, guinea pig, rabbit and rat. By this means quantitative changes in the relative fractions of the two forms of collagen were determined during the first eight weeks of postnatal growth for each type of rat bone. Quantitative biochemical data on whole rat bones (calvarium, femur, humerus) confirmed measurements based on histology which showed that at birth rat calvaria are mostly uncalcified as compared to other species whose bones are mostly ossified at birth. With growth rat membranous bones ossify more rapidly than long bones.     

Comparison of whole calvarial bones and long bones during early growth in rats. Histology and collagen composition

The distribution of ossified collagen (bone) and uncalcified collagen (fibrous tissue and cartilage) was compared histologically for rat and dog calvaria at birth. The relative amount of bone and uncalcified collagen was quantitated morphologically for rat calvaria during the first four weeks of rapid growth. Whereas dog calvaria are essentially ossified at birth, rat calvaria at birth consist mostly of fibrous tissue but rapidly become ossified with growth. Bacterial collagenase was used to separate uncalcified collagen from calcified collagen of whole membranous bones (frontal and parietal) and long bones (femur and humerus) at birth from man, monkey, dog, guinea pig, rabbit and rat. By this means quantitative changes in the relative fractions of the two forms of collagen were determined during the first eight weeks of postnatal growth for each type of rat bone. Quantitative biochemical data on whole rat bones (calvarium, femur, humerus) confirmed measurements based on histology which showed that at birth rat calvaria are mostly uncalcified as compared to other species whose bones are mostly ossified at birth. With growth rat membranous bones ossify more rapidly than long bones.     

Dose reduction in CT while maintaining diagnostic confidence: diagnostic reference levels at routine head, chest, and abdominal CT--IAEA-coordinated research project

PURPOSE: To measure radiation doses for computed tomography (CT) of the head, chest, and abdomen and compare them with the diagnostic reference levels, as part of the International Atomic Energy Agency Research coordination project. MATERIALS AND METHODS: The local ethics committees of all participating institutions approved the study protocol. Written informed consent was obtained from all patients. All scanners were helical single-section or multi-detector row CT systems. Six hundred thirty-three patients undergoing head (n = 97), chest (n = 243), or abdominal (n = 293) CT were included. Collected data included patient height, weight, sex, and age; tube voltage and tube current-time product settings; pitch; section thickness; number of sections; weighted or volumetric CT dose index; and dose-length product (DLP). The effective dose was also estimated and served as collective dose estimation data. RESULTS: Mean volumetric CT dose index and DLP values were below the European diagnostic reference levels: 39 mGy and 544 mGy . cm, respectively, at head CT; 9.3 mGy and 348 mGy . cm, respectively, at chest CT; and 10.4 mGy and 549 mGy . cm, respectively, at abdominal CT. Estimated effective doses were 1.2, 5.9, and 8.2 mSv, respectively. CONCLUSION: Comparison of CT results with diagnostic reference levels revealed the need for revisions, partly because the newer scanners have improved technology that facilitates lower patient doses.