Bilateral reversed palmaris longus muscle: a rare anatomical variation.

We report a case of bilateral reversed palmaris longus muscle (PLM). The muscle was tendinous in its upper portion and muscular in its lower portion in both arms. This rare variation has been mentioned only once in the literature as a surgical finding. According to the literature, a reversed PLM may cause a compartment syndrome in the wrist area, carpal tunnel, and Guyon's syndrome. The described variation is also useful to the hand surgeon as a tendon graft, a tendon for transfer, or as an anatomical landmark for operations at this area.

Localization and characterization of carbohydrates in adrenal medullary cells.

The localization and characterization of carbohydrates in adrenal medullary cells were studied by histochemical and cytochemical methods. Adrenaline (A)-and noradrenaline (N)-storing granules were argentaphobic when ultrathin sections of Araldite-embedded medullae were stained according to the periodic acid-thiocarbohydrazide-silver proteinate technique of Thiery. A small amount of glycogen in the form of single beta-particles as well as lysosomes were, however, visualized by this technique. The entire core of the A granules was markedly positive after ultrathin sections of glutaraldehyde-fixed, glycol methacrylate (GMA)-embedded medullae were stained with phosphotungstic acid (PTA) at low pH (0.3). The N granules, in contrast, were mostly unreactive. In the A cells, PTA stained a large part of the Golgi complex, whereas in the N cells the Golgi complex was mostly unstained. In both cell types, the cell coat, lysosomes, and multivesticular bodies reacted to PTA. The periodic acid-Schiff (PAS) technique showed A but not N granules in semithin sections of GMA- or Araldite-embedded medullae. The PTA and PAS stains were abolished by acetylation, restored by saponification, unchanged by methylation, and greatly diminished by sulfation. In ultrathin sections of GMA- or Araldite-embedded medullae incubated with colloidal iron according to various techniques, the cell coat and lysosomes of both cell types were stained, unlike all the other cytoplasmic organelles. These results indicate that A granules and the Golgi complex of A cells, unlike the same structures in N cells, are rich in glycoproteins which are probably not acidic.

DNA synthesis in cultured adult cardiocytes.

Trypsin-dissociated atrial cardiocytes from adult rats were exposed to [3H]thymidine for sequential 24-hour periods from day 2 to day 12 of culture. On day 3 and each day thereafter, cells were prepared for ultrastructural radioautography and examined with an electron microscope. Maximal incorporation occurred on day 5, when 63 percent of the cardiocytes were labeled. Mitotic activity was never present in more than 0.5 percent of the cardiocytes examined. Incorporation of [3H]thymidine and mitosis occurred only in immature cardiocytes characterized by subsarcolemmal primary filaments and Z bands with or without specific granules; more mature cardiocytes were never labeled.

The heart and the atrial natriuretic factor.

The search for natriuretic hormones or factors by studies of negative pressure breathing, atrial distension experiments, head-out water immersion, expansion of blood volume, Na+/K+-ATPase inhibitors and parabiosis experiments in Dahl rats has led to the finding that the atria are a peptide-secreting endocrine gland. This new natriuretic hormone has now been purified, sequenced and synthetized, and its cDNA and gene have been cloned. The native and synthetic hormones exert identical wide ranging effects (possibly through particulate guanylate cyclase stimulation and adenylate cyclase inhibition) on the kidney, blood vessels, adrenal cortex, and pituitary. Physiopathologic implications of the hormone in experimental hypertension, congestive heart failure, and expansion of blood volume are beginning to emerge.

Histomorphometric analysis of unilateral condylar hyperplasia in the temporomandibular joint: the value of the condylar layer and cartilage island.

This study aimed to describe the condylar layer and cartilage island in subjects with unilateral condylar hyperplasia (UCH). Five individuals (15-18 years old) with a diagnosis of UCH, treated in a university hospital in Temuco, Chile, were included. The analysis examined the presence, extension, and thickness of the layers on the condylar surface, the number, depth, and area of the cartilage islands, and the argyrophilic proteins of the nucleolar organizer region (AgNOR) score. Statistical significance was set at P<0.05. The fibrocartilaginous layer was thickest (0.13±0.05mm) and the joint layer was thinnest (0.07±0.01mm) (P<0.05). With respect to the number, depth, and area of the islands, case 1 presented the highest values, followed by case 2; the cartilage island was related to the fibrocartilaginous layer (P<0.05). All cases had AgNOR proteins in the proliferative and fibrocartilaginous layers, as well as the islands with the greatest presence of chondrocytes (P=0.245). A relationship was observed between the histopathological alterations in the different layers on the condylar surface and the thickness of the fibrocartilaginous layer, as well as the thickness of the latter and the number, depth, and area of the cartilage islands in the trabecular bone.

Light and electron microscope study of osmotically induced tumor necrosis.

Necrosis of 1.5-cm Walker 256 tumors was produced by injecting a strongly hypertonic solution of glucose in and around the growths and by delaying resorption of the solution with serotonin, given s.c. at a distance. The morphological changes occurring in 13 tumors were followed by light and electron microscopic analysis of samples taken 0.25, 0.5, 1, 1.5, 3, and 5 hr after treatment. The 0.25-hr samples showed mitochondrial swelling, loss of cristae, and flocculent material within the inner compartment. Swelling of the mitochondria persisted in the 0.5-hr specimens (as it did in all subsequent samples), and it was accompanied by clumping and margination of chromatin. These changes were more pronounced at 1 hr, at which time the nuclear and plasma membranes were frequently ruptured. The endoplasmic reticulum and Golgi complex could no longer be recognized. The 3-hr material revealed ruptures of the outer mitochondrial membrane with myelin figures and discontinuous cell membranes. In the 5-hr samples, the nuclei exhibited a dark nucleoplasm and large clumps of chromatin. The perinuclear membrane was not always recognizable.

Histopathological analysis of unilateral condylar hyperplasia: difficulties in diagnosis and characterization of the disease.

The aim of this study was to perform a histological analysis of the conditions in patients undergoing surgery for unilateral condylar hyperplasia (UCH) using different histopathological analytical techniques and to describe the complications and existing controversy in order to better define the disease. A partial condylectomy was performed in five patients who had been diagnosed with UCH using clinical and imaging methods. The samples obtained were analyzed using routine histological techniques including haematoxylin-eosin, Van Gieson, picrosirius, alcian blue/haematoxylin-eosin, and AgNOR staining. The analyses were performed by an observer who was blinded to the clinical parameters of the disease. The cellularity, tissue layers, size of the anatomical structures, and the relationships between them were assessed. The analysis of these patients was complemented by a review of the scientific literature. Variability was observed in the analysis of the cases. The presence of connective tissue was detected at the bone level, with cartilage formation at different levels. Each island presented levels of involvement that could indicate various degrees of aggressiveness. Type I collagen was observed in most cases, although type III was also identified. The development of histological diagnostic methods to determine the aggressiveness or level of involvement in UCH is not currently possible. Further studies are needed to establish new histological classifications.

Atrial natriuretic factor during atrial fibrillation and supraventricular tachycardia.

Plasma immunoreactive atrial natriuretic factor was measured in 10 patients with chronic atrial fibrillation before and after cardioversion to sinus rhythm, and in 14 patients during electrophysiologic evaluation of paroxysmal supraventricular tachycardia. The mean plasma concentration of atrial natriuretic factor in atrial fibrillation was 138 +/- 48 pg/ml and decreased to 116 +/- 45 pg/ml 1 hour after cardioversion to sinus rhythm (p less than 0.005). The mean plasma concentration of atrial natriuretic factor increased from 117 +/- 53 pg/ml in sinus rhythm to 251 +/- 137 pg/ml during laboratory-induced supraventricular tachycardia (p less than 0.005). Right atrial pressures were recorded in 12 patients; the baseline atrial pressure was 4.3 +/- 1.9 mm Hg and increased to 7.4 +/- 3.6 mm Hg during supraventricular tachycardia (p less than 0.005). A modest but significant linear relation was noted between the changes in plasma atrial natriuretic factor and right atrial pressure measurements during induced supraventricular tachycardia (r = 0.60, p less than 0.05). In conclusion, changes in atrial rhythm and pressure may be an important factor modulating the release of atrial natriuretic factor in the circulation and raised levels of this hormone may be a contributing factor for the polyuria and the hypotension associated with paroxysmal supraventricular tachyarrhythmias.

A murine monoclonal antibody against rat atrial natriuretic factor (ANF) which cross-reacts with mouse ANF.

A monoclonal antibody (MAb), 2H2, against rat synthetic atrial natriuretic factor (ANF) (Arg101-Tyr126) recognizes native ANF related peptides. The lack of reactivity of 2H2 with amino-terminal truncated ANF peptides implicates the two amino terminal arginine residues of ANF in the 2H2 epitope. Similarly, poor immunoreactivity of human ANF indicates the participation of isoleucine 110. Arginines 101 and 102 and isoleucine 110 may thus participate in a conformational epitope recognized by 2H2 or alternatively, substitution for, or elimination of these residues may alter the conformation of the 2H2 epitope. The MAb shows little cross-reactivity with extracts of rabbit atria but recognizes ANF related peptides in mouse and hamster atrial extracts. 2H2 also identifies immunoreactive ANF in histological sections of rat, mouse and hamster atria.

Glomerular and vascular atrial natriuretic factor receptors in cardiomyopathic hamsters: correlation with the peptide biological effects.

STUDY OBJECTIVE: The aim was to study glomerular and vascular atrial natriuretic factor (ANF) receptors and their relationship with the post-receptor effects of the peptide in experimental heart failure. DESIGN: Binding sites ANF were studied in renal glomerular and mesenteric artery membranes. The natriuretic and relaxing effects of ANF were evaluated in the intact animal and in noradrenaline precontracted aortic strips respectively. Plasma and tissue ANF levels were also assessed. EXPERIMENTAL MATERIAL: The study was performed on cardiomyopathic (UM-X7.1) hamsters (n = 15) with a moderate degree of heart failure. Age matched Golden Syriam hamsters (n = 15) were used as controls. MEASUREMENTS AND MAIN RESULTS: Cardiomyopathic hamsters presented lower blood pressure, body weight, and plasma Na+, and higher heart weight than normal hamsters. Plasma ANF (1-98) and (99-126) levels and ventricular ANF content were higher in cardiomyopathic hamster than in controls. ANF and frusemide decreased blood pressure, and increased diuresis and natriuresis in normal hamsters. The blood pressure reduction by ANF in cardiomyopathic hamsters was approximately of the same magnitude as in normal hamsters but their renal response was blunted. The blood pressure lowering effect of frusemide was similar in both cardiomyopathic and normal hamsters, but the diuretic and natriuretic responses were greatly reduced in the former. Glomerular ANF receptor density was higher and receptor affinity was lower in cardiomyopathic hamsters than in controls. Noradrenaline precontracted vascular strips from cardiomyopathic hamster were more sensitive to the relaxant effect of ANF than those from controls. No differences in either density or affinity of vascular receptor were observed. CONCLUSIONS: The results suggest that the renal hyporesponsiveness of cardiomyopathic hamsters to ANF is not due to a down regulation of glomerular ANF receptors. The fact that the natriuretic response to frusemide is also blunted suggest the involvement of other factors.

Bilateral mandibular fourth molars: A case report.

INTRODUCTION: Fourth molars are supernumerary teeth located distal to the third molars that may cause local alterations. Therefore an adequate diagnosis and treatment are essential. Removal of the supernumerary tooth and, in selected cases, maintenance of the tooth on the arch and frequent observation are the preferred treatments. If the extraction is recommended, it should be performed carefully by experienced oral surgeons to prevent damage to the anatomical structures. OBSERVATION: The oral examination of a 26-year-old woman revealed a left partially impacted mandibular molar responsible for pain and infection. Although it was assumed it was a third molar, the panoramic radiograph showed that the real third molar was completely impacted and that two partially impacted mandibular fourth molars were present bilaterally. Both of them were removed without complications and the left third molar was extracted after fragmentation to avoid any injury of the contiguous inferior alveolar nerve. DISCUSSION: The extraction of the left fourth molars solved the pain. Even if the right fourth molar was asymptomatic, the patient accepted its extraction because of the evident radiographical pericoronitis and to avoid further complications. "Asymptomatic" does not mean absence of disease, but the patient's consent is mandatory before any decision.

Electrical Stimulation in the Bone Repair of Defects Created in Rabbit Skulls.

Electrical stimulation has been used in different conditions for tissue regeneration. The aim of this study was to analyze the tissue response of defects created in rabbit skulls to electrical stimulation. Two groups were formed, each with 9 New Zealand rabbits; two 5 mm defects were made, one in each parietal, with one being randomly filled with autogenous bone extracted as particles and the other maintained only with blood clotting. The rabbits were euthanized at 8 weeks and 15 weeks to then study the samples collected histologically. In the 8-week analysis bone formation was observed in the defects in the test and control filled with bone graft, whereas the defects with clotting presented a very early stage of bone formation with abundant connective tissue. At 15 weeks an advanced stage of bone regeneration was identified in the defects with bone graft, whereas no significant differences were found in the electrically stimulated defects. In conclusion, electrical stimulus does not alter the sequence of bone formation; new studies could help establish patterns and influences of the stimulus on bone regeneration.

Estrogens directly down-regulate receptors for angiotensin II in anterior pituitary cell culture without decreasing target cell responsiveness.

Chronic estradiol treatment in vivo has been shown to reduce the density of receptors for angiotensin II (ANG II) in the anterior pituitary lobe (AP). We studied whether estradiol is directly involved in the down-regulation of ANG II receptors, using AP cells in culture. Binding affinity and density of ANG II receptors were measured in disrupted AP cells with the radiolabeled antagonist [125I]Sar1, Ile8-ANG II ([125I]SARILE). Estradiol treatment (10 nM) for either 48 or 96 h caused a marked reduction (approximately 70%) in the density of receptors for ANG II in cultured AP cells, with no change in the dissociation constant of [125I]SARILE (Kd, 0.5 +/- (SE) 0.1 nM). In the AP, specific binding sites for ANG II are present in lactotrophs and ANG II has been shown to release prolactin (PRL). In AP cells treated with estradiol for 48 h, dose-response curves revealed that ANG II still increased PRL release (P less than 0.01). The average net PRL release (ANG II-stimulated minus basal) was greater in estradiol-treated cells than in controls, whereas the half-maximal stimulation dose (ED50) of ANG II was the same (0.07 +/- 0.04 nM). These results suggest that estrogens are directly involved in the modulation of ANG II receptors in the AP, causing marked receptor down-regulation without decreasing target cell responsiveness.

Processing of the atrial natriuretic factor propeptide by atrial cardiocytes as revealed by immunocryoultramicrotomy.

Antibodies were raised against three fragments of the rat ANF molecule: C-terminal atrial natriuretic factor (ANF)-(101-126), N-terminal ANF-(11-37), and the putative cleavage site of the ANF propeptide, ANF-(94-103). These antibodies were purified by affinity chromatography and revealed a major band (17K) corresponding to the propeptide by Western blot analysis. Antibodies against ANF-(94-103) were used in a RIA. All of the peptides that possess this region (98-99) were able to displace iodinated pro-ANF from the antibody. However, peptides that have only one part of the fragment, such as ANF-(99-126) or ANF-(1-98), failed to displace pro-ANF; human ANF-(79-98) (100 pmol) demonstrated about 0.01% cross-reactivity. Immunohistochemical studies revealed that all atrial cardiocytes are reactive with the three antibodies. Immunocryoultramicrotomy revealed that the propeptide travels, uncleaved, from the Golgi complex to immature granules and mature secretory granules. These results indicate that cleavage of the ANF propeptide does not occur at these sites.

Cardiac and plasma atrial natriuretic factor in experimental congestive heart failure.

The cardiac and plasma levels of immunoreactive (IR-) atrial natriuretic factor (ANF) in cardiomyopathic hamsters with moderate and severe congestive heart failure were measured, compared with those of controls, and correlated by HPLC analysis of IR-ANF in atria, ventricles, and plasma and with the ultrastructure of atrial and ventricular cells. Congestive heart failure in the hamster produced a significant increase in plasma IR-ANF, a significant decrease in atrial IR-ANF, and a marked increase in ventricular IR-ANF. The HPLC pattern of IR-ANF was of the high mol wt type in atria and ventricles of control and cardiomyopathic animals. High mol wt forms of ANF appeared in the plasma of animals with severe congestive heart failure, but not in controls. Severe congestive heart failure produced a tremendous increase in the size of the Golgi complex, with a decrease in the number and size of secretory granules in atrial cardiocytes. Ventricular cardiocytes also showed a less marked increase in the size of the Golgi complex. Secretory-like granules indistinguishable from lysosomes were present in about 1% of ventricular cardiocytes of control hamsters; in hamsters with severe congestive heart failure, secretory granules, identical to those of atrial cardiocytes, were present in greater number in about 20% of ventricular cardiocytes. Immunocytochemistry (immunogold technique) revealed that secretory granules containing IR-ANF are not present in control ventricular cardiocytes but are localized in relatively large number in about 20% of ventricular cardiocytes in hamsters with severe congestive heart failure. These results suggest that the increased IR-ANF levels (including the high mol wt forms) in animals with congestive heart failure may come from hypersecretion of both atrial and ventricular cardiocytes.

Specific receptor-mediated inhibition by synthetic atrial natriuretic factor of hormone-stimulated steroidogenesis in cultured bovine adrenal cells.

The effect of synthetic atrial natriuretic factor (ANF) on adrenal steroidogenesis has been studied in primary culture of bovine adrenal cells. ANF-(8-33) produced a potent 40-70% inhibition of angiotensin II-, ACTH-, PGE1-, and forskolin-stimulated secretion of aldosterone production from zona glomerulosa cells with an ED50 of 120 pM. An equipotent inhibitory effect of the natriuretic factor on cortisol production was also observed in cultured zona fasciculata cells. Nicotine-stimulated secretion of catecholamines from medullary cells was only slightly inhibited by the factor at doses above 10 nM. [125I]iodo-ANF-(8-33) binding to glomerulosa membranes displayed an apparent affinity of 100-150 pM for specific receptor sites and was not inhibited by angiotensin II or ACTH. Conversely, the natriuretic factor had no affinity for angiotensin II receptor sites. The results demonstrate that part of the natriuretic effect of this new factor might be due to inhibition of adrenal steroidogenesis by action through a distinct receptor.

Identification and localization of 7B2 protein in human, porcine, and rat thyroid gland and in human medullary carcinoma.

The novel, highly conserved polypeptide 7B2, which belongs to a new protein superfamily, was isolated from human and porcine hypophysis. The availability of a specific antibody to a synthetic fragment enabled 7B2 localization in a number of neurocrine and endocrine tissues and revealed its secretory character. 7B2 was purified from thyroid homogenates by HPLC chromatography and characterized by gel permeation chromatography (dimeric mol wt, approximately 40,000) and sodium dodecyl sulfate-polyacrylamide gel electrophoresis (monomeric mol wt, 20,750). By immunocytochemistry 7B2 was colocalized with calcitonin in parafollicular cells and identified within secretory granules by electron microscopy. Three of nineteen human medullary carcinoma cases showed immunoreactive 7B2 within the early and late hyperplasia stages and neoplasia. Results suggest that 7B2 may play a role in endocrine function, possibly as a secretory substance, and may be a histochemical marker in addition to calcitonin for medullary carcinoma.

Fate of [125I]angiotensin II in adrenal zona glomerulosa cells.

Binding and internalization of [125I]angiotensin II (AII) were studied by morphological and biochemical methods in rats in vivo. Light microscope radioautography demonstrated that [125I]AII binds specifically to adrenal zona glomerulosa (ZG) cells. Ultrastructural radioautographic analysis revealed that [125I]AII binds to the cell surface, clusters in coated pits, is internalized in coated vesicles, and is transported by receptosomes to lysosomes in less than 20 min. Biochemical analysis revealed that as much as 40% of the adrenal radioactive uptake behaves as native [125I]AII as shown by electrophoresis, immunoprecipitation and radioligand binding studies. These results indicate that the effects of AII on the secretion of aldosterone by ZG cells are mediated by cell surface phenomena and not by binding to intracellular organelles involved in steroidogenesis. They also indicate that the half-life of AII bound to receptors and internalized seems to be much longer (min) than in the systemic circulation (sec).

Internalization and lysosomal association of [125I]angiotensin II in norepinephrine-containing cells of the rat adrenal medulla.

The morphological localization of [125I]angiotensin II (AII) in the rat adrenal medulla (AM) was studied by light- and electron-microscopic radioautography in vivo. With light microscopy the presence of binding sites for AII in both norepinephrine-containing (NE) and epinephrine-containing (E) cells was confirmed. With electron microscopy, it was found that AII binds to the cell surface of NE cells, is progressively internalized, and is associated with lysosomes and Golgi complex within 20 min, whereas in E cells AII seems to be internalized earlier and recycled back to the cell surface within 5 min without any appreciable association with intracellular organelles. These results suggest different intracellular pathways for AII in NE and E cells of the rat AM.

The heart as an endocrine gland.

The sequence of atrial natriuretic factor (ANF) has been determined, as well as the complete structure of the rat and human complementary DNA and gene. ANF and ANF messenger RNA are present not only in atria but also in ventricles. The circulating form of ANF has been identified as the C-terminal of the molecule, ANF (Ser 99-Tyr 126). The isolated secretory granules of rat atrial cardiocytes contain only pro-ANF (Asn 1-Tyr 126). An enzyme (IRCM-SP1) has been isolated from heart atria and ventricles. This enzyme is highly specific in cleaving ANF (Asn 1-Tyr 126), to yield ANF (103-126), (102-126), and (99-126). In target cells, ANF produces a rise in cyclic guanosine 3',5'-monophosphate (cGMP) due to activation of particulate guanylate cyclase, and inhibition of adenylate cyclase leading in some cases to a decrease in cyclic adenosine 3',5'-monophosphate (cAMP). ANF produces relaxation of rabbit and rat aortic strips, inhibits steroidogenesis in both zona glomerulosa and zona fasciculata cells, and inhibits the release of arginine vasopressin from the isolated rat hypothalamohypophysial preparation in vitro but decreases AVP release in vivo only at pharmacological doses. In all forms of experimental hypertension, plasma levels of ANF are increased and, at some time periods, atrial levels are also decreased. The ventricular levels of immunoreactive ANF are also increased in renal hypertension. Infusion of ANF by minipumps decreases the blood pressure near control levels in several models of experimental hypertension. In cardiomyopathic hamsters with heart failure, the atrial levels of immunoreactive ANF are decreased while the plasma and ventricular levels are increased.(ABSTRACT TRUNCATED AT 250 WORDS)