Deep femoral artery: A new point of view based on cadaveric study.

INTRODUCTION: In diagnostic angiographic procedures, the knowledge of arterial variations in the femoral artery (FA), deep femoral artery (DFA) and lateral and medial circumflex femoral arteries (LCFA, MCFA) has a great impact. MATERIAL AND METHODS: The frequency of branching patterns of these arteries was investigated in 111 thighs of body donors. Gender and side differences were analyzed statistically. RESULTS: The median distance of separation of the DFA from the FA in relation to the inguinal ligament (IL) was 3.29 cm. High origins (1-2 cm below IL) and middle origins (3-5 cm below IL) of the DFA were found in an equal distribution of 39.3% and 41.1%, respectively. Low origins (6-10 cm below IL) were rare (19.6%) but showed a tendential significance toward expression in males (p = 0.096). The origin of the LCFA from the FA (19.8%) or DFA (70.2%) are in line with the findings of other groups. The origin of the MCFA from FA (14.4%) or DFA (74.7%) showed that circumflex femoral arteries arose mostly from DFA. A trifurcation of the FA into the DFA, LCFA and MCFA was only observed in 9.9% and, therefore, less frequently than reported by others. Branches of the femoral nerve (FN) passed mostly anterior (46.4%) or anterior and posterior (47.8%) to the LCFA. The rare constellation of branches of FN passing only posterior to the LCFA (5.8%) showed a tendential significance to left side expression (p = 0.084). CONCLUSIONS: Taken together, this is the first classification of the median distance of separation of the DFA from the FA in relation to the IL in three defined groups. The knowledge of DFA branching pattern is essential for recent therapy options of cardiac diseases using a femoral artery access: transcatheter aortic valve replacement, catheter-based miniaturized ventricular assist device and veno-arterial extracorporal membrane oxygenation. The variant topography of the branches of FN in relation to LCFA should be kept in mind when harvesting an anterolateral thigh flap.

Thermoregulation at birth differs between piglets from two genetic lines divergent for residual feed intake.

Thermoregulation is essential to piglets' neonatal survival. This study used infrared thermography (IRT) to assess thermoregulation abilities of piglets from two lines divergent for residual feed intake (RFI). At birth, morphology (weight, length, width and circumference), vigour (respiration, mobility and vocalisation), and rectal temperature were recorded from piglets of the 11th generation of the low RFI (LRFI, more efficient; n = 34) and the high RFI (HRFI, less efficient; n = 28) lines. Infrared thermography images were taken at 8, 15, 30 and 60 min post partum. Temperatures of the ear base and tip, and of the back (i.e. shoulders to rumps) were extracted (Thermacam Researcher Pro 2.0) and analysed with linear mixed models (SAS 9.4). Piglets had different average hourly weight gain (HRFI = 7.1 ±â€¯1.3 g/h, LRFI = 3.6 ±â€¯1.3 g/h; P < 0,001) but did not differ in morphology or vigour. All temperatures increased overtime. At birth, piglets' rectal temperature was correlated with the initial temperature of the ear base and the maximum back temperature (0.37 and 0.33, respectively; P < 0.05). High residual feed intake piglets had lower ear tip temperatures than LRFI piglets at 15 (24.7 ±â€¯0.37 °C vs. 26.3 ±â€¯0.36 °C, respectively; F1, 63.5 = 9.11, P < 0.005) and 30 min post partum (26.2 ±â€¯0.47 °C vs. 27.6 ±â€¯0.44 °C, respectively; F1, 66.9 = 4.52, P < 0.05). Moreover, thermal pattern of the ear tip differed between the two genetic lines. In conclusion, IRT allowed non-invasive assessment of piglets' thermoregulation abilities and indicated an influence of genetic selection for RFI on neonatal thermoregulation abilities.

In vitro differentiation of the immortalized mesencephalic progenitor cell line CSM14.1 occurs independently from haematopoietic cytokines.

In vitro expanded neural precursor cells could provide a renewable source of dopaminergic (DAergic) neurons for cell replacement therapy. In the present study immortalized cell line CSM14.1 was investigated in vitro. Cells were derived from the ventral mesencephalic area of a 14-day-old rat embryo and immortalized retrovirally with the temperature-sensitive mutant of the SV40 Large T-antigen. We investigate the proliferation and differentiation of these cells under various culture conditions, at different temperatures and serum conditions. For differentiation were propagated cells at 39 degrees C in medium supplemented with 1% FCS with or without cytokines. At chosen time points cells were investigated for the expression of different markers by western blot and immunocytochemistry. As controls cells cultured at 33 degrees C with 10% FCS for 3 days were used. We have shown that serum reduction alone is not sufficient for CSM14.1-cells to stop proliferating and begin differentiation. Following serum reduction and elevation of the temperature cells changed their morphology began to express specific band of the neuronal marker NeuN. Following cytokines treatment the mean length of cellular processes increased from 319 to 385 microm per cell, whereas the expression of neuronal markers such as NeuN and TH was not markedly changed. In conclusion, the differentiation cocktail consisting of interleukin 1(Il-1), Il-11, leukaemia inhibitory factor (LIF) and GDNF, does influence the outgrowth of neuritis but does not change the expression of mature neuronal markers at the protein level in CSM14.1 cells.

The respiratory sinus arrhythmia: a measure of cardiac age.

A method developed for quantifying respiratory sinus arrhythmia (RSA) during voluntary cardiorespiratory synchronization relies on computer-assisted rhythmometric cosinor analysis of instantaneous heart rate data. The RSA was present in all subjects tested, even those at advanced ages. The amplitude of the RSA falls approximately 10 percent per decade. An individual with a transplanted heart and one with severe diabetic neuropathy each had resting RSA values that were normal for their ages. The shape and amplitude of the RSA during voluntary cardiorespiratory synchronization may reflect the suppleness of the heart and its response to rhythmically changing intrathoracic pressure and the subsequent ebb-and-flow of venous return. Our technology allows objective quantitative assessment of the biologic age of the heart and also the effect of any drug, disease, or behavior that affects the RSA.

Nurse sow strategies in the domestic pig: I. Consequences for selected measures of sow welfare.

Management strategies are needed to optimise the number of piglets weaned from hyper-prolific sows. Nurse sow strategies involve transferring supernumerary new-born piglets onto a sow whose own piglets are either weaned or fostered onto another sow. Such 'nurse sows' have extended lactations spent in farrowing crates, which could have negative implications for their welfare. This study used 47 sows, 20 of which farrowed large litters and had their biggest piglets fostered onto nurse sows which were either 1 week (2STEP7, n=9) or 3 weeks into lactation (1STEP21, n=10). Sows from which piglets were removed (R) were either left with the remainder of the litter intact (I) (remain intact (RI) sows, n=10), or had their litters equalised (E) for birth weight using piglets of the same age from non-experimental sows (remain equalised (RE) sows, n=9). Piglets from 2STEP7 were fostered onto another nurse sow which was 3 weeks into lactation (2STEP21, n=9). Back-fat thickness was measured at entry to the farrowing house, at fostering (nurse sows only) and weaning. Sows were scored for ease of locomotion and skin and claw lesions at entry to the farrowing house and weaning. Salivary cortisol samples were collected and tear staining was scored at 0900 h weekly from entry until weaning. Saliva samples were also taken at fostering. Data were analysed using GLMs with appropriate random and repeated factors, or non-parametric tests were applied where appropriate. Back-fat thickness decreased between entry and weaning for all sows (F 1,42=26.59, P<0.001) and tended to differ between treatments (F 4,16=2.91; P=0.06). At weaning RI sows had lower limb lesion scores than 2STEP7 and RE sows (χ 2 4=10.8, P0.05) and all nurse sows had a higher salivary cortisol concentration at fostering, compared with the other days (F 10,426=3.47; P<0.05). Acute effects of fostering differed between nurse sow treatments (F 2,113=3.45, P0.05). In conclusion, no difference was detected between nurse sows and non-nurse sows in body condition or severity of lesions. Although some nurse sows experienced stress at fostering, no long-term effect of the nurse sow strategies was detected on stress levels compared with sows that raised their own litter.

Nurse sow strategies in the domestic pig: II. Consequences for piglet growth, suckling behaviour and sow nursing behaviour.

Nurse sow strategies are used to manage large litters on commercial pig farms. However, new-born piglets transferred to nurse sows in late lactation might be compromised in terms of growth and survival. We investigated the effects of two nurse sow strategies on piglet growth, suckling behaviour and sow nursing behaviour. At 1-day post-farrowing, the four heaviest piglets from large litters were transferred to a nurse sow either 21 (1STEP21, n=9 litters) or 7 (2STEP7, n=10 litters) days into lactation. The remainder of the litter remained with their mother and was either kept intact (remain intact (RI), n=10 litters) or had some piglets cross-fostered to equalise birth weights (remain equalised (RE), n=9 litters). The 7-day-old piglets from 2STEP7 were transferred onto a sow 21 days into lactation (2STEP21, n=10 litters). The growth of new-born piglets on 1STEP21 and 2STEP7 nurse sows was initially lower than in RI litters (F 3,33.8=4.61; P<0.01), but weaning weights did not significantly differ (F 4,32.7=0.78; P>0.5). After the 1st week of lactation, the weights and growth rates did not differ between treatments. Fighting behaviour during nursing bouts decreased over time. The frequency of fights was higher in 1STEP21 and 2STEP21 litters compared with RI litters (t 122=3.06 and t 123=3.00, respectively, P<0.05). The 2STEP21 litters had shorter nursing bouts than RI and 1STEP21 litters (t 107=-2.81 and t 81.7=2.8, respectively, P<0.05), which were more frequently terminated by 2STEP21 than RI sows (t 595=2.93; P<0.05). Transferring heaviest piglets from RI and RE litters to nurse sows reduced the percentage of teat changes during nursing bouts (RI: F 1,275=16.61; RE: F 1,308=43.59; P<0.001). In conclusion, nurse sow strategies do not appear to compromise piglet growth. However, new-born piglets transferred onto sows in late lactation experienced more competition at the udder, suggesting that the sows' stage of lactation is of importance to how achievable nurse sow strategies are. Thus, the two-step nurse sow strategy is likely the best option (in relation to growth and suckling behaviour), as it minimises the difference between piglet age and sow stage of lactation.

Dopamine, Noradrenaline and Serotonin Receptor Densities in the Striatum of Hemiparkinsonian Rats following Botulinum Neurotoxin-A Injection.

Parkinson's disease (PD) is characterized by a degeneration of dopaminergic neurons in the substantia nigra pars compacta (SNpc) that causes a dopamine (DA) deficit in the caudate-putamen (CPu) accompanied by compensatory changes in other neurotransmitter systems. These changes result in severe motor and non-motor symptoms. To disclose the role of various receptor binding sites for DA, noradrenaline, and serotonin in the hemiparkinsonian (hemi-PD) rat model induced by unilateral 6-hydroxydopamine (6-OHDA) injection, the densities of D1, D2/D3, α1, α2, and 5HT2A receptors were longitudinally visualized and measured in the CPu of hemi-PD rats by quantitative in vitro receptor autoradiography. We found a moderate increase in D1 receptor density 3 weeks post lesion that decreased during longer survival times, a significant increase of D2/D3 receptor density, and 50% reduction in 5HT2A receptor density. α1 receptor density remained unaltered in hemi-PD and α2 receptors demonstrated a slight right-left difference increasing with post lesion survival. In a second step, the possible role of receptors on the known reduction of apomorphine-induced rotations in hemi-PD rats by intrastriatally injected Botulinum neurotoxin-A (BoNT-A) was analyzed by measuring the receptor densities after BoNT-A injection. The application of this neurotoxin reduced D2/D3 receptor density, whereas the other receptors mainly remained unaltered. Our results provide novel data for an understanding of the postlesional plasticity of dopaminergic, noradrenergic and serotonergic receptors in the hemi-PD rat model. The results further suggest a therapeutic effect of BoNT-A on the impaired motor behavior of hemi-PD rats by reducing the interhemispheric imbalance in D2/D3 receptor density.

Prediction of regional functional impairment following experimental stroke via connectome analysis.

Recent advances in functional connectivity suggest that shared neuronal activation patterns define brain networks linking anatomically separate brain regions. We sought to investigate how cortical stroke disrupts multiple brain regions in processing spatial information. We conducted a connectome investigation at the mesoscale-level using the neuroVIISAS-framework, enabling the analysis of directed and weighted connectivity in bilateral hemispheres of cortical and subcortical brain regions. We found that spatial-exploration induced brain activation mapped by Fos, a proxy of neuronal activity, was differentially affected by stroke in a region-specific manner. The extent of hypoactivation following spatial exploration is inversely correlated with the spatial distance between the region of interest and region damaged by stroke, in particular within the parietal association and the primary somatosensory cortex, suggesting that the closer a region is to a stroke lesion, the more it would be affected during functional activation. Connectome modelling with 43 network parameters failed to reliably predict regions of hypoactivation in stroke rats exploring a novel environment, despite a modest correlation found for the centrality and hubness parameters in the home-caged animals. Further investigation in the inhibitory versus excitatory neuronal networks and microcircuit connectivity is warranted to improve the accuracy of predictability in post-stroke functional impairment.

Functional neuroanatomy of pain.

Pain is an unpleasant but important biological signal for danger. Nociception is necessary for survival and for maintaining the integrity of the organism in a potentially hostile environment. Pain is induced by noxious stimuli that act on a complex pain sensory apparatus. However, chronic pain no longer affords a protective role, but can become a ruining disease itself, termed "neuropathic pain". This contribution throws light on the complex machinery of pain processing, from the perspective of the connections between key structures that are necessary for a profound understanding of the phenomenon of pain.

Nitric oxide synthase-containing neurons in the amygdaloid nuclear complex of the rat.

The nitric oxide-producing neurons in the rat amygdala (Am) were studied, using reduced nicotinamide adenine dinucleotide phosphate diaphorase (NADPHd) histochemistry. Almost all nuclei of the Am contained NADPHd-positive neurons and fibers, but the somatodendritic morphology and the intensity of staining of different subpopulations varied. The strongly stained neurons displayed labeling of the perikaryon and the dendritic tree with Golgi impregnation-like quality, whilst the dendrites of the lightly stained neurons were less successfully followed. Many strongly positive neurons were located in the external capsule and within the intraamygdaloid fiber bundles. A large number of small, strongly stained cells was present in the amygdalostriatal transition area. In the Am proper, a condensation of deeply stained cells occurred in the lateral amygdaloid nucleus. In the basolateral nucleus, the strongly NADPHd-positive neurons were few, and were located mainly along the lateral border of the nucleus. These cells clearly differed from the large, pyramidal, and efferent cells. The basomedial nucleus contained numerous positive cells but most of them were only lightly labeled. A moderate number of strongly stained neurons appeared in the medial division of the central nucleus, and a larger accumulation of strongly positive cells was present in the lateral and the capsular divisions. The medial amygdaloid nucleus contained numerous moderately stained neurons and displayed the strongest diffuse neuropil staining in Am. In the nucleus of the lateral olfactory tract, the first layer contained only NADPHd-stained axons, in the second layer, there were numerous moderately stained cells, and in the third layer, a few but deeply stained neurons. From the cortical nuclei, the most appreciable number of stained neurons was seen in the anterior cortical nucleus. The anterior amygdaloid area contained numerous NADPHd-positive neurons; in its dorsal part the majority of cells were only moderately stained, whereas in the ventral part the neurons were very strongly stained. The intercalated amygdaloid nucleus lacked NADPHd-positive neurons but an appreciable plexus of fine, tortuous axons was present. In the intra-amygdaloid part of the bed nucleus of the stria terminalis (st) some lightly stained cells were seen but along the entire course of st strongly stained neurons were observed. Some Am nuclei, and especially the central lateral nucleus and the intercalated nucleus, display considerable species differences when compared with the primate Am. The age-related changes of the nitrergic Am neurons, as well as their involvement in neurodegenerative diseases is discussed.

Brain stem afferent connections of the amygdala in the rat with special references to a projection from the parabigeminal nucleus: a fluorescent retrograde tracing study.

A recently revealed important function of the amygdala (Am) is that it acts as the brain's "lighthouse", which constantly monitors the environment for stimuli which signal a threat to the organism. The data from patients with extensive lesions of the striate cortex indicate that "unseen" fearful and fear-conditioned faces elicit increased Am responses. Thus, also extrageniculostriate pathways are involved. A multisynaptic pathway from the retina to the Am via the superior colliculus (SC) and the pulvinar was recently suggested. We here present data based on retrograde neuronal labeling following injection of the fluorescent tracer Fluoro-Gold in the rat Am that the parabigeminal nucleus (Pbg) emits a substantial, bilateral projection to the Am. This small cholinergic nucleus (Ch8 group) in the midbrain tegmentum is a subcortical relay visual center that is reciprocally connected with the SC. We suggest the existence of a second extrageniculostriate multisynaptic connection to Am: retina-SC-Pbg-Am, that might be very effective since all tracts listed above are bilateral. In addition, we present hodological details on other brainstem afferent connections of the Am, some of which are only recently described, and some others that still remain equivocal. Following selective injections of Fluoro-Gold in the Am, retrogradely labeled neurons were observed in parasubthalamic nucleus, peripeduncular nucleus, periaqueductal gray, dopaminergic nuclear complex (substantia nigra pars lateralis and pars compacta, paranigral, parabrachial pigmented and interfascicular nuclei, rostral and caudal linear nuclei, retrorubral area), deep mesencephalic nucleus, serotoninergic structures (dorsal, median and pontine raphe nuclei), laterodorsal and pedunculopontine tegmental nuclei (Ch6 and Ch5 groups), parabrachial nuclear complex, locus coeruleus, nucleus incertus, ventrolateral pontine tegmentum (A5 group), dorsomedial medulla (nucleus of the solitary tract, A2 group), ventrolateral medulla (A1/C1 group), and pars caudalis of the spinal trigeminal nucleus. A bilateral labeling of the upper cervical spinal cord was also observed.

Neurons in the dorsal column nuclei of the rat emit a moderate projection to the ipsilateral ventrobasal thalamus.

The dorsal column nuclei (DCN; gracile and cuneate nuclei) give rise to the medial lemniscus, the fibre system that provides an organised somatosensory input to the thalamus. Unlike the spinothalamic and trigeminothalamic tracts that project, also to the ipsilateral thalamus, the medial lemniscus system is believed to be entirely crossed. We demonstrate that DCN emit a small number of axons that reach the ipsilateral thalamus. As retrograde fluorescent neuronal tracer Fluoro-gold was stereotaxically injected in the ventrobasal thalamus of nine young adult Wistar rats. The injection foci were voluminous and encroached upon adjacent nuclei, but the periphery of the injection halo never spilled over to the contralateral thalamus. All sections of the contralateral gracile and cuneate nuclei and the midline nucleus of Bischoff contained abundant retrogradely labelled neurons. The comparison with the Nissl-stained parallel sections suggests that approximately 70-80% of the DCN neurons project to the contralateral thalamus. Counting of retrogradely labelled neurons in two cases revealed 4,809 and 4,222 neurons in the contralateral and 265 and 214 in the ipsilateral DCN, respectively. Thus, although less prominent than the ipsilateral spinothalamic tract, the lemniscal system also emits an ipsilateral projection that accounts for about 5% of the neuronal population in DCN that innervates the ventrobasal thalamus.

Three-dimensional cytoarchitectonic analysis of the posterior bank of the human precentral sulcus.

Studies employing functional magnetic resonance imaging have identified the human frontal eye field as being in the anterior and partly in the posterior wall, as well as at the base of the precentral sulcus. Moreover, it is known that the frontal eye field extends rostrally to the superior frontal sulcus. According to Brodmann's cytoarchitectonic map, this region belongs to the dysgranular Brodmann area 6 of the premotor cortex. However, the frontal eye field in non-human primates has been located within the arcuate sulcus in Brodmann area 8, generating considerable debate about where to locate exactly the frontal eye field in humans. Functional studies of the primate frontal eye field have revealed a principal homology of voluntary saccadic control systems in human and old-world monkeys, especially the macaque. But these homologies seem to be contradicted by the reported topographic localization at the cytoarchitectonic level. Therefore, we studied the cytoarchitectonic structure of the posterior bank of the precentral sulcus of a human brain, employing newly developed spatial mapping techniques to provide data about whether or not this region should be considered cytoarchitecturally homogeneous or heterogeneous. We used functional magnetic resonance imaging results, as an initial guide in localizing a region which is activated by saccadic tasks. A maximum of activation was detected around the junction of the superior frontal sulcus and the precentral sulcus extending 1.5 cm along the precentral sulcus in direction of the lateral sulcus. Here, one human brain has been analyzed to obtain preliminary data about the cytoarchitectonical changes of a part of area 6. Statistical analysis of the three-dimensional architectonic data from this region allowed us to identify a zone at the posterior bank, which in other studies has been associated with a functional region that controls pursuit eye movements and performs sensory-to-motor transformations. We found two significant sectors along the ventral part of the posterior bank of the precentral sulcus. The caudal transition region coincides partly with a region that integrates retinal and eye position signals for target location, arm, and axial movements. The second more ventrally located region is attributed to process oral-facial movements. The caudal transition region coincides with our functional magnetic resonance imaging investigation. It was revealed that this region lies at the inferior frontal eye field, where a pronounced activation over a larger region can be stimulated. Currently, more studies are needed to combine functional magnetic resonance imaging data of maximal activation with data from whole histologic brain sections of more individuals and to quantify the variability of this region and its sub-regions by means of a standardized brain atlas.

Therapeutic outcome and side-effects after radiotherapy, chemotherapy and/or hyperthermia treatment of head and neck tumour xenografts.

The aim of the study was to optimise the still unsatisfactory therapeutic results in head and neck cancer by studying the results and the side-effects of radiotherapy, chemotherapy and/or local hyperthermia treatment of human tumour xenografts. Mice carrying human-derived head and neck squamous cell carcinoma xenografts with a mean volume of 100 mm(3) received 5x2 Gy, cisplatin or ifosfamide and/or local hyperthermia at 41/41.8 degrees C. Haematocrit and tumour volumes were determined two or three times per week, respectively, until day 25 or day 60. At day 60, the highest number of complete remissions (CRs) (80%) was observed in the triple modality therapy group with radiation, local hyperthermia at 41.8 C and cisplatin at a dosage of 2 mg/kg body weight (b.w.). Therapeutic side-effects were moderate weight loss and a mild anaemia. Thus, with regard to the long-term tumour-free survival, the most effective treatment was the combination of radiotherapy, cisplatin and local hyperthermia at 41.8 C.

Analysis of nerve fibers and their distribution in histologic sections of the human brain.

The field of quantitative analysis and subsequent mapping of the cerebral cortex has developed rapidly. New powerful tools have been applied to investigate large regions of complex folded gyrencephalic cortices in order to detect structural transition regions that might partition different cortical fields of disjunct neuronal functions. We have developed a new mapping approach based on axoarchitectonics, a method of cortical visualization that previously has been used only indirectly with regard to myeloarchitectonics. Myeloarchitectonic visualization has the disadvantage of producing strong agglomerative effects of closely neighbored nerve fibers. Therefore, single and neurofunctional-relevant parameters such as axonal branchings, axon areas, and axon numbers have not been determinable with satisfying precision. As a result, different staining techniques had to be explored in order to achieve a suitable histologic staining for axon visualization. The best results were obtained after modifying the Naoumenko-Feigin staining for axons. From these contrast-rich stained histologic sections, videomicroscopic digital image tiles were generated and analyzed using a new fiber analysis framework. Finally, the analysis of histologic images provided topologic ordered parameters of axons that were transferred into parameter maps. The axon parameter maps were analyzed further via a recently developed traverse generating algorithm that calculated test lines oriented perpendicular to the cortical surface and white matter border. The gray value coded parameters of the parameter maps were then transferred into profile arrays. These profile arrays were statistically analyzed by a reliable excess mass approach we recently developed. We found that specific axonal parameters are preferentially distributed throughout granular and agranular types of cortex. Furthermore, our new procedure detected transition regions originally defined by changes of cytoarchitectonic layering. Statistically significant inhomogeneities of the distribution of certain axon quantities were shown to indicate a subparcellation of areas 4 and 6. The quantification techniques established here for the analysis of spatial axon distributions within larger regions of the cerebral cortex are suitable to detect inhomogeneities of laminar axon patterns. Hence, these techniques can be recommended for systematic and observer-supported cortical area mapping and parcellation studies.

The fetal spinal canal--a three-dimensional study.

The size of the lumbar spinal canal was evaluated in a prospective cross-sectional ultrasound (US) study to determine normal size values for lumbar part of the vertebral canal. A total of 88 patients undergoing routine obstetric US were studied between 16-41 weeks gestation. Structural anomalies or growth restriction were excluded. Area and volume of the vertebral canal in L1, L3 and L5 were calculated by three-dimensional (3-D) US. The size of the spinal canal correlated well with gestational age and no major differences could be found between upper and lower lumbar spine. By 3-D US, in vivo assessment of the spinal canal becomes possible. Further studies are needed to confirm our findings.

Radiographic spinal profile changes induced by cage design after posterior lumbar interbody fusion preliminary report of a study with wedged implants.

STUDY DESIGN: A prospective comparative radiographic study between two geometrically varying implants utilized in single-level posterior lumbar interbody fusion (PLIF) was performed. OBJECTIVE: The aim of this study was to determine the influence of 4 degrees wedged cages on postoperative lateral lumbar spinal profile. SUMMARY OF BACKGROUND DATA: The biomechanical and clinical importance of realigning the sagittal lumbar profile in surgical management of spinal instabilities is known. Wedged cages are therefore increasingly attaining popularity in PLIF. As yet the significance of wedged implants on postoperative sagittal spinal profile has not been assessed. METHODS: Forty patients were randomly assigned to two equal-sized groups. In one group rectangular cages and in the second group cages with a wedged design and an inclination of 4 degrees were implanted. Quantitative assessment of the lumbar spinal profile on standing neutral lateral radiographs was performed before surgery as well as 6 weeks and 12 months after surgery. Results were statistically compared. RESULTS: A significant improvement of lumbar sagittal profile after use of 4 degrees wedged compared with nonwedged cages was not found. The greatest effect on lumbar profile and segmental lordosis was observed in fusion of segment L4-L5 with 4 degrees wedged cages. CONCLUSIONS: These results show that normal sagittal alignment after single-level lumbar fusion can be achieved with rectangular and 4 degrees wedged cages. Although results after utilization of 4 degrees wedged cages do not significantly differ, these implants offer the surgeon one more sizing variation with which physiologic lumbar lordosis may be attained. The biomechanical implications of wedged implants on the rigidity of a fused segment remain to be analyzed.

Systematic investigations of the contrast results of histochemical stainings of neurons and glial cells in the human brain by means of image analysis.

The investigation of neurohistological specimens by image analysis has become an important tool in morphological neuroscience. The problems which arise during the processing of these images are non-trivial, especially if a pattern recognition of cells in the imaged tissue is intended. One of the major problems faced concerns the segmentation of structures of interest, whether cells or other histologic structures. The segmentation problem is often the result of an inappropriate staining procedure. For serious image analysis to be performed, the material under investigation must be optimally prepared. Spatially complex patterns, e.g. fuzzy-like neighbouring neurons, are easy to recognize for humans. But the integrative and associative performance of current artificial neuronal network schemes is too low to achieve the same recognition quality as humans do. Therefore, a general analysis of staining characteristics was performed, especially with respect to those stains which are relevant to object segmentation. Although most image analytical investigations of tissues are based on stained samples, a study of this type has not been previously conducted. Of the stains and procedures evaluated, the gallocyanin chrome alum combination staining provided the best stain contrast. Furthermore, this staining method shows sufficient constancy within different parts of the human brain. Even the fine nuclear textures are differentiable and can be used for further pattern recognition procedures.

Evaluation of chronic tears of the rotator cuff by ultrasound. A new index.

The diagnosis of chronic lesions of the rotator cuff is challenging. We have developed a new index to improve the sonographic diagnosis of chronic tears of the cuff. In a pilot study, we examined 50 asymptomatic healthy volunteers by ultrasound to establish the diameter of the rotator cuff in relation to the tendon of the long head of biceps. Subsequently, the index was calculated in 64 patients who had had shoulder pain for more than three months caused by clinically diagnosed lesions of the rotator cuff. The compensatory hypertrophy of the biceps tendon was quantified sonographically in relation to the diameter of the cuff. Comparison with the contralateral shoulder revealed a significantly higher biceps rotator-cuff ratio (p < 0.05) for patients with torn rotator cuffs. A ratio greater than 0.8 was considered pathological (index positive); the mean ratio in the control group was 0.43. The sensitivity of a positive index was 97.8%, the specificity 63.2%, the positive predictive value 86.3%, and the negative predictive value 92.4% in comparison with surgical findings. Use of the index improves sensitivity in the diagnosis of chronic tears of the cuff by ultrasound.

Microvascular response of striated muscle to metal debris. A comparative in vivo study with titanium and stainless steel.

Wear products of metal implants are known to induce biological events which may have profound consequences for the microcirculation of skeletal muscle. Using the skinfold chamber model and intravital microscopy we assessed microcirculatory parameters in skeletal muscle after confrontation with titanium and stainless-steel wear debris, comparing the results with those of bulk materials. Implantation of stainless-steel bulk and debris led to a distinct activation of leukocytes combined with a disruption of the microvascular endothelial integrity and massive leukocyte extravasation. While animals with bulk stainless steel showed a tendency to recuperation, stainless-steel wear debris induced such severe inflammation and massive oedema that the microcirculation broke down within 24 hours after implantation. Titanium bulk caused only a transient increase in leukocyte-endothelial cell interaction within the first 120 minutes and no significant change in macromolecular leakage, leukocyte extravasation or venular diameter. Titanium wear debris produced a markedly lower inflammatory reaction than stainless-steel bulk, indicating that a general benefit of bulk versus debris could not be claimed. Depending on its constituents, wear debris is capable of eliciting acute inflammation which may result in endothelial damage and subsequent failure of microperfusion. Our results indicate that not only the bulk properties of orthopaedic implants but also the microcirculatory implications of inevitable wear debris play a pivotal role in determining the biocompatibility of an implant.