Loss of sympathetic nerve fibers in vital intertrochanteric bone cylinders lateral to osteonecrosis of the femoral head.

OBJECTIVES: Although etiology in osteonecrosis of the femoral head mainly depends on alterations of bone blood flow, vasoregulatory nerve fibers of the sympathetic and sensory nervous system have never been investigated in bone of osteonecrosis patients. This study aimed to demonstrate density of sympathetic and sensory nerve fibers in femoral head and, for comparison, adjacent periosteum, and synovium of the hip joint in patients with osteonecrosis. METHODS: Immunofluorescence staining techniques were applied using specific nerve fiber markers. A total of 10 patients with early femoral head osteonecrosis (ARCO I-II), 10 with late femoral head osteonecrosis (ARCO III-IV), and 10 patients with osteoarthritis of the hip were investigated. RESULTS: In the bone of the femoral head, density of sympathetic nerve fibers was lower in early and late osteonecrosis compared to osteoarthritis. There was a marked preponderance of sympathetic over sensory nerve fibers in bone of osteoarthritis patients, which was opposite in early and late femoral head osteonecrosis. In periosteum, density of sympathetic nerve fibers was similar in all three groups but density of sensory nerve fibers and cellularity were higher in early osteonecrosis compared to the other two groups. DISCUSSION/CONCLUSIONS: Due to the different affinity of norepinephrine for α-adrenoceptors (high affinity) and ß-adrenoceptors (low affinity), the loss of sympathetic nerve fibers relative to sensory nerve fibers in femoral head osteonecrosis might change the femoral head blood flow (towards α-adrenergic vasoconstriction). Higher density of sensory nerve fibers and cellularity in periosteum might indicate an inflammatory response in early osteonecrosis.

Proximal femoral epiphysis anatomy in chilean population: orthopedic and forensic aspects / Anatomía del epífisis proximal del fémur en la población chilena. Aspectos traumatológicos y forenses

From a biomechanical standpoint, bone geometry and density are factors correlated to the bone resistance of the femur when supporting body weight, with geometric parameters like the diameter of the femoral head and neck, the length of the femoral neck, and the femoral neck angle as determinant factors in the incidence of hip fractures, which increase in frequency and seriousness in osteoporotic patients. In Chile, morphometric data that contributes to relating the anatomy of the proximal epiphysis of the femur as an associated factor in hip fractures does not exist; likewise, there are no anthropometric indexes that may contribute to the forensic sciences. The purpose of this study is to establish average measurements of the proximal epiphysis of the femur in the adult Chilean population. Descriptive Study. The proximal epiphyses of 81 dry adult femurs were analyzed (44 right and 37 left bones), measuring the following parameters: length of the femoral neck (LN), femoral neck angle (FNA), circumference of the femoral head (CH) and circumference of the femoral neck (CN). The statistical relationship between the measurements and the side of each sample was analyzed (t-test p=0.05). The average lengths were LN= 3.59cm (+/- 0.43 cm); FNA= 124.17 (+/- 6.37), CH= 14.34 cm (+/- 1.27 cm) and CN= 9.7 cm (+/- 0.87 cm). No significant differences between the left and right sides were found. Average numbers were obtained for the anatomy of the proximal femoral epiphysis from a sample in the Chilean population. With the data obtained, we propose to carry out anatomo-clinical, epidemiologic and forensic studies in this population.

Desde un punto de vista biomecánico, la geometría y la densidad ósea son factores correlacionados con la resistencia del hueso del fémur al apoyar el peso corporal, con los parámetros geométricos, como el diámetro de la cabeza femoral y el cuello, la longitud del cuello del fémur, y el ángulo del cuello femoral factores determinantes en la incidencia de fracturas de cadera, que aumentan en frecuencia y gravedad en los pacientes con osteoporosis. En Chile, no existen datos morfométricos que relacionen la anatomía de la epífisis proximal del fémur como un factor asociado a las fracturas de cadera ni índices antropométricos que pueden contribuir a las ciencias forenses. El propósito de este estudio es establecer las medidas promedio de la epífisis proximal de fémur en población adulta chilena. Estudio Descriptivo. Se analizaron la epífisis proximal de 81 fémures adultos secos (44 derechos y 37 izquierdos), midiendo los siguientes parámetros: longitud del cuello femoral (LC) , ángulo cérvico-diafisiario femoral (ACD), circunferencia de la cabeza femoral (CCa) y circunferencia del cuello femoral (CCu). Se analizó la relación estadística de las medidas con el lado de cada muestra (test Chi cuadrado p:0,05) Las longitudes promedios fueron LC: 3,59 cm (+/- 0,43 cm); ACD: 124,17 (+/- 6,37 cm); CCa: 14,34 cm (+/- 1,27 cm) y CCu: 9,7 cm (+/- 0,87 cm). No se encontraron diferencias significativas entre el lado derecho e izquierdo. Los resultados proponen la necesidad de realizar estudios anatomo-clínicos y epidemiológicos actualizados en población chilena donde la geometría de la epífisis proximal del fémur se incluya dentro del análisis.

To investigate the role of the nervous system of bone in steroid-induced osteonecrosis in rabbits.

SUMMARY: Glucocorticoid treatment frequently causes osteonecrosis of the femoral head. The precise mechanism in the pathogenesis of osteonecrosis remains highly controversial. Normal bone metabolism requires a coordinated interaction between the sensory/sympathetic nervous system and cells within the bone tissue. So we speculated that neural lesions may be involved in osteonecrosis. OBJECTIVE: using a rabbit model, we investigated the relationship between neural factors and steroid-induced osteonecrosis of the femoral head. METHODS: Japanese white rabbits weighing about 3.5 kg each were injected with a single intramuscular dose of methylprednisolone 4 mg/kg and then divided into three groups (groups A, B and C) consisting of 15 rabbits each. The rabbits of group A were killed after 3 days, those of group B after 1 week, and those of group C after 2 weeks. As a control group, 10 rabbits (group N) were fed under the same conditions but did not receive a steroid injection. An immunohistochemical study of the femoral heads was conducted using the monoclonal antibodies CGRP, SP, VIP, NPY and NGF. Also, using the software Image Pro Plus, the areas showing positive immunoreactivity in each group were calculated and the four groups were compared. RESULTS: significant changes were seen in the expression of CGRP, SP, VIP and NPY nerve fibres and of NGF immunoreactivity in the subchondral bone of the femoral head and these changes were associated with the process of osteonecrosis. Furthermore, CGRP, SP, NPY and NGF (but not VIP) showed marked changes in expression 1 week after steroid administration, and this is the time when osteonecrosis is thought to occur in this model. CONCLUSION: This study showed that osteonecrosis in rabbits is chronologically associated with changes in neural factors.

Identification of poxvirus under transmission electron microscopy during outbreak period in wild birds, in São Paulo, Brazil / Identificación de poxvirus por microscopía electrónica de transmisión durante período de brote en aves silvestres en São Paulo, Brasil

Avianpox is a highly contagious disease infecting both commercial and wild birds, causing great damages to breeders and breeding. Caused by DNA viruses of the family Poxviridae, genus Avipoxvirus, if manifest through 3 forms, cutaneous, diphtheric and septicemic. In June 2003, during illegal commercialization of Brazilian birds, 800 wild birds (Paroaria dominicana, Sporophila caerulescens and Sporophila albogularis) were apprehended and being forwarded to the CRAS (Wild Animals Recovery Center), Tietê Ecological Park. After one month, birds presented cutaneous lesions in the beak and feet and anorexia, emaciation, locomotion difficulties, diarrhea, dehydration and death. Among the 800 birds, 500 died and 40 these (15 Paroaria dominicana, 15 Sporophila caerulescens and 10 Sporophila albogularis) were sent to the Electron Microscopy Laboratory of the Biology Institute of São Paulo, SP, to investigate viral agents. Scabs and fragments of skin lesions collected of theses birds were processed for transmission electron microscopy utilizing negative staining (rapid preparation), resin embedding and immunocitochemistry techniques. Under the transmission electron microscopy in all the analyzed samples it was visualized two types of poxvirus particles, M form, with regular spaced thread-like ridges comprising the exposed surface, measuring 280 x 230 nm; C form or stain-penetrated particle showing the dumbbell-shaped core surrounded by the outer envelope, measuring 360 x 330 nm. In the ultrathin sections obtained, three types of intracytoplasmic inclusion bodies were encountered: type A or Bollinger body, outlined by membrane, containing in its interior a great number of mature particles, measuring 200 x 300 nm, revealing the inner dumbbell-shaped core, two lateral bodies and an external envelope. In the type B electron dense inclusions bodies, viral particles budding of dense amorphous material were observed. Fibrillar inclusions constituted by ...

Avianpox es una enfermedad altamente contagiosa que infecta tanto aves comerciales como aves silvestres, causando grandes daños a lo ganadería y a la crianza. Causados por los virus de ADN de la familia Poxviridae, género Avipoxvirus, se manifiestan a través de 3 formas, cutánea, diftérica y septicémica. En junio del 2003, durante la comercialización ilegal de aves brasileñas, 800 aves silvestres (Paroaria dominicana; Sporophila caerulescens; Sporophila albogularis) fueron capturadas y remitidas al CRAS (Centro de Recuperación de Animales Silvestres), Parque Ecológico de Tietê. Después de un mes, las aves presentaron lesiones cutáneas en el pico y las patas, anorexia, adelgazamiento, dificultades de locomoción, diarrea, deshidratación y muerte. 500 de las 800 aves murieron, 40 de éstas (15 Paroaria dominicana, 15 Sporophila caerulescens y 10 Sporophila albogularis) fueron enviadas al Laboratorio de Microscopía Electrónica del Instituto de Biología de São Paulo, SP, para investigar agentes virales. Costras y fragmentos de lesiones en la piel de estas aves fueron recolectadas y se procesaron para microscopía electrónica de transmisión utilizando tinción negativa (preparación rápida), incrustación de resina y técnica inmunocitoquímica. Bajo la microscopía electrónica de transmisión en todas las muestras analizadas se encontraron dos tipos de partículas de poxvirus, Forma M, con espacios regulares como hilo que abarcan toda la superficie expuesta, midiendo 280 x 230 nm; Forma C o partícula teñida por penetración mostrando núcleo en forma de pesa rodeado por una envoltura externa, que medía 360 x 330 nm. Se encontraron en secciones ultrafinas, tres tipos de cuerpos de inclusión intracitoplásmica: el tipo A o cuerpo de Bollinger, esbozado por la membrana, que contiene en su interior un gran número de partículas maduras, que miden 200 x 300 nm, revelando núcleo interno en forma de pesa, dos cuerpos laterales y una envoltura externa. En el tipo ...

Innervation of the ligament of the femoral head in the formosan rock monkey: a retrograde HRP tracing and ultrastructural study.

The innervation of the ligament attached to the femoral head of the Formosan rock monkey (Macaca cyclopis, Swinhoe) was investigated by means of the retrograde HRP tracing method and by electron microscopy. WGA/HRP was injected into the ligament of the left femoral head. Numerous neurons labelled with HRP were found in the ipsilateral lumbar sympathetic ganglia, from L1 to L7, with a peak in the L3 to L5 region. Labelled neurons were also found in the ipsilateral spinal dorsal root ganglia, from L1 to L7 and concentrated at L4. Ultrastructurally, the nerve fascicles to the ligament had an average diameter at 32.8 microns. They contained both myelinated and unmyelinated axons and accompanied the blood vessels. Sensory receptors were not found in the ligamentum proprium but free nerve endings were observed in the walls of the blood vessels. The present results indicate that the nerve fibres to the ligament of the femoral head may be involved in regulating blood vessel calibre in addition to having a sensory function.

[Neurologic manifestations in aseptic necrosis of the head of the femur and structural features of its innervation]. / Nevrologicheskie proiavleniia pri asepticheskom nekroze golovki bedrennoi kosti i strukturnye osobennosti ee innervatsii.

Examination of 54 patients with aseptic necrosis of the femoral head showed that the most characteristic alterations related to this pathology include vegetative-trophic disturbances in zones of autonomic innervation of neurometamers LIII = LIV. Characteristics of the innervation of the femoral head were studied in man and experimental animals.

A histological demonstration of nerves in subchondral bone.

Several different staining procedures were carried out on decalcified histological sections from human femoral heads to demonstrate the nerves in subchondral bone. The femoral heads were obtained at surgery from patients with fractures of the femoral neck or osteoarthritic hip joints. The Bodian technique was found to be the most suitable. Serial sections were used in order to disclose the various sources of error. It was not possible to demonstrate nerves in the bone matrix, but they were easily seen in the subchondral bone marrow, after related to the vessels. A comparison of the fracture and osteoarthritic cases revealed an obvious difference; more nerves were seen in osteoarthritis. The method described is considered suitable for further study of the nerves in osteoarthritic femoral heads.