Maternal and postnatal high-fat diets with high ω6 : ω3 ratios affect the reproductive performance of male offspring in the mouse.

High-fat diets (HFDs) are an acknowledged risk factor for male subfertility, but the underlying mechanisms remain unclear. In the present study we compared the effects of two HFDs with different ω6:ω3 ratios, one enriched with soy oil (SOD; ω6:ω3=9.62) and another enriched with sunflower oil (SFOD; ω6:ω3=51.55), with those of a commercial diet (CD; ω6:ω3=19.87), supplied from pregnancy to adulthood, on morphometric parameters and reproductive performance in adult male mice (recommended ω6:ω3 for rodents=1-6). Bodyweight was significantly higher in the SFOD than CD group, and relative testicular weight was significantly lower in the SFOD than the other two groups. SFOD altered sperm performance: it reduced sperm viability (mean±s.e.m.; 76.00±1.35% vs 82.50±1.45% and 80.63±1.00% in the SFOD vs CD and SOD groups respectively; P<0.05) and increased the percentage of immature spermatozoa (71.88±7.17% vs 51.38±5.87% and 48.00±5.72% in the SFOD vs CD and SOD groups respectively; P<0.05). The epididymal ω6:ω3 ratio was higher in the SFOD versus CD and SOD groups, whereas the unsaturation index was higher in the SOD and SFOD groups than in CD group. Sperm membrane integrity was diminished in both the SOD and SFOD groups, but there was no difference in sperm reactive oxygen species production in these two groups compared with the CD group. The fertilisation rate was lower in the SFOD compared with the CD and SOD groups. In conclusion, although both HFDs affected sperm quality, the fertilising ability was more altered by the excessive dietary ω6:ω3 ratio than by the net ω6 content.

Mouse plasma progesterone levels are affected by different dietary ω6/ω3 ratios.

An imbalance in the dietary polyunsaturated fatty acids (PUFAs) ω6/ω3 ratio, could influence negatively the reproductive performance. The aim of the study was to assess the effects of chronic administration of diets enriched with soybean or sunflower oils with different ω6/ω3 ratios on the reproductive parameters of adult female mice. Mice were fed different diets for 90 days: a commercial diet (CD), a 5 or 10% soy oil-enriched diet (SOD5 and SOD10, respectively), and a 5 or 10% sunflower oil-enriched diet (SFOD5 and SFOD10, respectively). The parameters evaluated were: body weight and food intake, estrous cycle, plasma progesterone concentration, ovulation rate, and oocyte quality. Progesterone concentrations (ng/ml) were significantly higher in the SFOD10: 14.9±2.8 vs CD: 5.4±1.2; SOD5: 5.6±1.1 and SFOD5: 4.6±1.4. Additional parameters evaluated were not affected. However, metestrous and luteal phases were shorter in subjects receiving SOD and longer in those under SFOD diets. In SFOD, there was a trend towards a smaller number of recruited oocytes compared to CD and SOD and a higher percentage of cleaved oocytes were quantified in SOD diets. A 3-month supply of a diet with elevated LA ω6/ALA ω3 ratio to adult female mice affects their reproductive physiology, modifying progesterone production, ovulation rate, and/or oocyte quality. Although some differences in the response to diets have been observed in several mammalian species, the present findings must be taken into consideration when a diet for optimizing reproductive capability is indicated.

Reproductive performance and fertility in male and female adult mice chronically treated with hexarelin.

Hexarelin (HEXr), a synthetic ghrelin analogue, has been associated with modifications of reproductive physiology. In previous studies of adult mice, we detected that HEXr induced significantly reduced ovulation rate and significant correlation coefficients between sexual maturation and corporal weight in offspring. In this study, we investigated the effects of chronic HEXr administration on sperm concentration and functional activity, oestrous cyclicity and pregnancy index, in addition to the number of fetuses and its correlation with the number of corpora lutea. Adult Albino swiss mice were injected (sc) daily with HEXr: 100 µgkg(-1) day(-1) (HEXr D1) or 200 µgkg(-1) day(-1) (HEXr D2) for 53 days in males and 30 days in females. We detected a significantly decreased ratio in the number of fetuses per corpora lutea in females treated with HEXr D2 for 30 days before mating and during the first 6 days of pregnancy, in addition to a downward trend in the pregnancy index and percentage of females impregnated by each male treated with both doses of the analogue. Although we did not find any significant effect on additional parameters evaluated in both genders, we propose certain effects of HEXr on the implantation process and/or early development of embryos and over the in vivo reproductive capability of males.

Inhibitory effects of ghrelin on sexual behavior: role of the peptide in the receptivity reduction induced by food restriction in mice.

Ghrelin (Ghr) is a gut/hypothalamus peptide with inhibitory actions on reproductive physiology; however, there are no previous reports of its role on estrous behavior. Under the hypothesis that the increase of plasma Ghr during food restriction (FR) is responsible for receptivity reduction, we intended to evaluate the receptivity percentage of female mice subjected to: exp. 1) acute and chronic FR and Ghr administration (3 nmol/animal/day, s. c.) and exp. 2) the co-administration of a ghrelin antagonist [ant=(d-Lys3)-GHRP-6; 6 nmol/animal/day s. c.]. All females were ovariectomized, primed with steroids, trained, and randomly subjected every week to each one of several protocols, followed by a behavioral test. Experiment 1 (n=8): basal, no treatment; acute FR (aFR), 24-h fasting; chronic FR (cFR), 50% FR for 5 days; acute ghrelin (aGhr), Ghr 30 min before test and chronic ghrelin (cGhr), Ghr for 5 days. Except for cGhr, all treatments significantly decreased the percentage of receptivity (mean±SEM): basal 61.9±6.0, aFR 33.1±8.1, cFR 18.8±7.7, aGhr 45.6±10.6, p<0.05 vs. basal. In exp. 2 (n=11), except for cFR+ant (55.0±6.4) the co-administration of the antagonist reversed the deleterious effects detected in exp. 1: basal 70.9±5.4; aFR+ant 72.3±7.6; aGhr+ant 73.6±4.7. As expected, the administration of vehicle or antagonist alone did not modify receptivity. Besides, we found a significant correlation between percentage of body weight loss and percentage of receptivity reduction (r=0.62, p=0.0004). This is the first study demonstrating that ghrelin is able to inhibit female mice sexual behavior and that is involved, at least in part, in receptivity reduction after food scarcity.

Effects of hexarelin (a ghrelin analogue) on fertilisation and the pre- and postnatal development of mice.

Ghrelin (Ghr) has been associated with reproductive physiology and pre- and postnatal development. The objectives of the present study were to evaluate the effects of hexarelin (HEX; 100 or 200 microg kg(-1) day(-1)), a therapeutic Ghr analogue, on: (1) embryo development 60 h post ovulation, induced pharmacologically, in pregnant mice; (2) the physical, neurobiological and sexual development of offspring of female mice injected with HEX during the first, second or third week of pregnancy or throughout the entire pregnancy; and (3) adult memory acquisition in these offspring. We also evaluated the effects of chronic HEX administration on memory acquisition in adult mice. Treatment of non-pregnant female mice with HEX decreased ovulation rate. However, treatment of pregnant mice with HEX at any time during pregnancy tended to accelerate offspring maturation, regardless of bodyweight. This effect was only significant on neurobiological parameters following treatment during the first week. HEX treatment during the first week and/or throughout the entire pregnancy resulted in impaired memory acquisition in the offspring, with female mice being more susceptible to these effects. Similar results were observed for the effects of chronic HEX treatment on memory acquisition in adult mice. In conclusion, HEX seems to exert differential effects depending on when it is administered. Because HEX has started to be used therapeutically, its deleterious effects on ovulation and memory acquisition must be further evaluated.

Li 1s core exciton in LiH studied by x-ray Raman scattering spectroscopy.

The Li 1s core excitation spectra in LiH was studied by means of x-ray Raman scattering (XRS) spectroscopy in a wide range of momentum transfers q. The analysis of the near-edge region of the measured spectra in combination with q-dependent ab initio calculations of XRS spectra based on the Bethe-Salpeter equation (BSE) reveals that the prominent peak at the excitation onset arises from two main contributions, namely a pre-edge peak associated to a p-type core exciton and strong transitions to empty states near the bottom of the conduction band, which is in contrast to previous experimental studies that attributed that feature to a single excitonic peak. The p-like angular symmetry of the core exciton is supported by BSE calculations of the relative contributions to the XRS spectra from monopole and dipole transitions and by the observed decrease of its normalised intensity for increasing momentum transfers. Higher energy spectral features in the measured XRS spectra are well reproduced by BSE, as well as by real-space multiple-scattering calculations.

Arthroscopic findings in acute fractures of the ankle.

We have evaluated prospectively the arthroscopic findings in acute fractures of the ankle in 288 consecutive patients (148 men and 140 women) with a mean age of 45.6 years. According to the AO-Danis-Weber classification there were 14 type-A fractures, 198 type B and 76 type C. Lesions of the cartilage were found in 228 ankles (79.2%), more often on the talus (69.4%) than on the distal tibia (45.8%), the fibula (45.1%), or the medial malleolus (41.3%). There were more lesions in men than in women and in general they were more severe in men (p < 0.05). They also tended to be worse in patients under 30 years and in those over 60 years of age. The frequency and severity of the lesions increased from type-B to type-C fractures (p < 0.05). Within each type of fracture the lesions increased from subgroups 1 to 3 (p < 0.05). The anterior tibiofibular ligament was injured with increased frequency from type-B.1 to type-C3 fractures (p < 0.05), but it was not torn in all cases. While lateral ligamentous injuries were seen more often in type-B than in type-C fractures (p < 0.05), no difference was noted in the frequency of deltoid ligamentous lesions. Our findings show that arthroscopy is useful in identifying associated intra-articular lesions in acute fractures of the ankle.

Function, osteoarthritis and activity after ACL-rupture: 11 years follow-up results of conservative versus reconstructive treatment.

ACL-reconstruction aims to restore joint stability and prevent osteoarthritis; however, malfunction and osteoarthritis are often the sequelae. Our study asks whether ACL-reconstruction or conservative treatment lead to better long-term results. In this retrospective cohort study, 136 patients with isolated ACL-rupture who had been treated by bone-ligament-bone transplant or conservatively were identified. Twenty-seven of these were excluded because of a revision operation in the 11.1 years follow-up period, leaving 109 patients (60 reconstructions and 49 conservatively treated) for evaluation based on clinical, radiological and internationally accepted knee-scores (Tegner, IKDC, Kellgren and Lawrence). An individual cohort study is classified as EBM level 2b according to the Oxford Centre of EBM. We observed significantly better knee-stability (P = 0.008) but more osteoarthritis (Grade II or higher) after ACL-reconstruction (42% vs. 25%). Physical activity levels were similar in both groups during the follow-up period (P = 0.16). Eleven years after ACL-rupture the physical activity levels are similar for both groups. After ACL-reconstruction, stability is higher as is osteoarthritis, whereby the result is not necessarily perceived as better subjectively. Specifically, this retrospective study yielded a 24% incidence of oseoarthrits 11 years after conservative management of ACL-rupture in patients not needing secondary surgery. The risk of secondary meniscal tears is reduced after ACL reconstruction, which reduces the negative effects of OA after surgery. The ultimate objective would be to achieve a good subjective outcome by conservative treatment followed by a rehabilitation program designed to keep secondary meniscus tears at a low level.

The SLAP lesion as a reason for glenolabral cysts: a report of five cases and review of the literature.

INTRODUCTION: Cysts in the spinoglenoidal or supraglenoidal incisura can be a cause of compression of the suprascapular nerve. There is agglomerated appearance of these cysts in combination with SLAP lesions. Hypothesis is SLAP lesions can lead to cysts in this region and should be repaired. MATERIAL AND METHODS: MRI of five patients (all male, four 30-40 years, one 75 years) showed cysts in the supralabral region. All were in combination with lesions of the superior glenoidal labrum (Type II or more). RESULTS: In two cases, in addition to cyst resection, the SLAP lesion was also repaired and symptoms disappeared completely and no recurrent cyst was detected in postoperative MRI. Two patients without SLAP repair showed recurrent cystic formation in MRI with similar complaints compared to their preoperative status. One patient (75 years) was treated primarily by puncture and afterwards with open resection of the cyst. His outcome was good in terms of activities of daily living without major pain. CONCLUSIONS: Our results are based on the assumption that cysts in the region of the spinoglenoidal/supraglenoidal incisura can originate from SLAP lesions. If a patient is suspected of having cysts in this region, the question of a SLAP lesion should be clarified. SLAP lesions should be repaired to avoid relapse. Arthroscopic repair of SLAP lesion can lead to the disappearance of symptoms in younger patients. In older patients puncture or resection of the ganglion alone may be an adequate therapeutic strategy.

[Knee ligament injuries]. / Ligamentäre Knieverletzungen in der Praxis.

Like no other joint of the human body the knee depends on intact ligaments. Knee instability due to ligament injuries will cause abnormal joint kinematics, and thereby is made responsible for secondary damage to other important knee joint structures. Diagnosis of knee ligament injuries is based on the detailed history with often typical injury patterns, as well as on the physical examination with specific knee ligament tests. In addition radiological evaluation is used. The range of knee ligament injuries is wide. Beginning with an isolated medial collateral ligament rupture which will heal with conservative treatment, they range to knee dislocation, a serious injury which needs emediate care and is associated with a high incidence of complications. Surgical procedures aim to reconstruct knee ligaments as anatomical as possible to provide for a long term stable knee joint.

Tunnel placement in anterior cruciate ligament (ACL) reconstruction: quality control in a teaching hospital.

Correct placement of the femoral and tibial bone tunnels is decisive for a successful anterior cruciate ligament (ACL) reconstruction. Our method of tunnel placement was evaluated as part of quality control at a teaching hospital. The emphasis was placed mainly on investigating the influence of surgical experience on tunnel placement, and the effect of tunnel position on the clinical outcome. Seventeen surgeons with different levels of experience (between 0 and >150 ACL reconstructions) performed endoscopic ACL repair in uniform technique from August 2000 to August 2003 on 50 patients (18 women, 32 men, age range 18-43 years). The patients were available to clinical and radiological follow-up after an average of 19 months. The clinical outcome was classified according to the International Knee Documentation Committee (IKDC) standard evaluation form. The femoral tunnel was evaluated according to the quadrant method of Bernard and Hertel; the position of the tibial bone tunnel was assessed according to the criteria of Stäubli and Rauschnig. The IKDC score revealed 47 (94%) patients with a normal (A) or nearly normal (B) knee joint at follow-up. According to the quadrant method, the femoral canal was situated on average at 29% in the saggital plane. The tibial tunnel was situated on average at 43% of the a.p. diameter of the tibial condyle. Statistical analysis of our data showed no significant correlation between tunnel placement and surgical expertise. However, a highly significant correlation was found (alpha<0.01) between the femoral position of the tunnel in the sagittal plane and the IKDC score. The more anterior the femoral canal, the poorer the IKDC score. The method of tunnel placement in ACL reconstruction being investigated here only showed slight dependence on surgical experience, whereby good short-term clinical outcomes were achieved. Therefore, the method is suitable for application at a teaching hospital. A far too anterior femoral tunnel placement will probably lead to a decline in the clinical result.

[Diagnosis and stage-related therapy of joint infections]. / Diagnostik und stadiengerechte Therapie von Gelenkinfekten.

BACKGROUND: Our management of septic arthritis is a combination of a stage-related arthroscopic irrigation, debridement and antibiotic therapy. At the start of therapy x-rays of the infected joint, leukocyte rate with differentiation and C-reactive protein level are necessary and aspiration of the joint should be performed for gram strain and crystal analysis. Additional imaging and laboratory tests can be needed for special indications. An arthroscopic staging of the initial joint infection has been shown to have prognostic and therapeutic consequences. Antibiotic therapy should start after aspirates and biopsy specimen have been taken intraoperatively and has to be adapted to the final results of the microbiology. Overall, antibiotic therapy is necessary for a period of 4-6 weeks, unless clinical findings and laboratory tests have returned to normal. A transition to oral administration of antibiotics is possible prior to patient release. INTRAOPERATIVE TREATMENT: Intraoperatively, the synovial membrane should be left intact. There is no indication for the intra-articular use of antibiotics and antiseptics. Wound drains are not necessary. If symptoms of infection persist under antibiotic therapy, arthroscopic irrigation can be repeated with good results.

Comparison of augmented and non-augmented anterior cruciate ligament reconstruction combined with high tibial osteotomy.

In a follow-up study 27 patients were evaluated after anterior cruciate ligament (ACL-)reconstruction combined with high tibial osteotomy because of chronic rupture of the ACL, cartilaginous lesions of the medial compartment and varus malalignment. They were divided into two groups. In 14 patients (non-LAD group) ACL reconstruction was performed using the central third of the autologous patellar tendon modified according to Eriksson-Trillat. Thirteen patients (LAD group) underwent repair with the same technique, but a Kennedy ligament augmentation device (LAD) in "hot dog' technique and fixed over the top was added. The postoperative treatment was the same in both groups. All patients were examined according to IKDC criteria. KT-1000 arthrometer testing at maximum manual traction was performed. Although the mean follow-up interval was more than double in the non-LAD group (non-LAD: 127 months vs LAD: 58 months), the subjective and clinical results, IKDC evaluation and KT-1000 arthrometer testing results were similar, showing no statistically significant difference. Further, no complications due to the use of LAD occurred. In this study no evident functional or clinical advantage from the augmentation performed could be shown.

An inelastic X-ray scattering spectrometer at LNLS.

A high-resolution spectrometer aimed at performing experiments of inelastic X-ray scattering by electronic excitations is described. The spectrometer has been installed at the D12A-XRD1 beamline of the National Synchrotron Light Laboratory (LNLS), in Campinas, Brazil. Synchrotron radiation is monochromated to about 6 keV and focused horizontally onto the sample by a sagittally focusing Si(111) double-crystal monochromator in non-dispersive setting. The spectrometer operates in Rowland circle geometry and is based on a focusing Si(333) analyser in near-backdiffraction geometry for energy analysis of inelastically scattered photons. The analyser works at a fixed Bragg angle, so energy transfers are obtained by varying the incident photon energy. A relative energy resolution of the whole spectrometer of approximately 1.5 x 10(-4) at 5.93 keV has been achieved. As an example of application, inelastic X-ray scattering by plasmon excitation in polycrystalline Be was measured. Test results demonstrate that inelastic X-ray scattering experiments with eV energy resolution and an acceptable counting rate are feasible at the LNLS when focused on plasmon and particle-hole excitations.

Anterior cruciate ligament reconstruction combined with valgus tibial osteotomy (combined procedure).

We assessed the patients who were operated on in a combined procedure from 1980 to 1992 with anterior cruciate ligament (ACL) insufficiency, cartilaginous lesions of the medial compartment, lesion of medial meniscus and varus malalignment. The combined operative procedure was autologous intra-articular ACL reconstruction with the middle third of the patellar ligament--partially augmented with Kennedy-ligament augmentation device (LAD) in hot dog technique--and high tibial osteotomy. The patients were examined according to the criteria of IKDC including testing of anterior stability with the KT-1000 arthrometer. Radiographically we checked axis and arthritis according to a modified score of Kannus. Twenty-seven of 34 patients who fulfilled the inclusion criteria could be followed up in three categories (2-5 years post-operatively, 5-10 years postoperatively, over 10 years post-operatively). Total qualification was good in 37%; there were no perioperative complications. Rehabilitation was not prolonged. Eighty-nine percent practised their preoperative job, over 50% had a higher level of sports activities than preoperatively, and more than 25% regained their pretraumatic sports capacity. Two-thirds had no giving way and less than 3 mm translation difference in comparison to the contralateral knee. Seventy-five percent of patients would accept the operation again. Radiological findings had no correlation to overall qualification. The encouraging results with respect to many of the criteria suggest using the combined procedure in a young patient with ACL insufficiency, varus malalignment and medial compartment damage including medial meniscus lesion.

Arthroscopic management of septic arthritis: stages of infection and results.

Seventy-six patients with septic arthritis (78 affected joints) were treated with a combination of arthroscopic irrigation, debridement, and antibiotic therapy according to the tested bacterial sensitivity. There were 62 knee, 10 shoulder, 5 ankle joints, and 1 hip joint. No antibiotics were added to the irrigating solution. The arthroscopic and radiological stage of infection, treatment, and outcome in these patients was analyzed. The patients were classified into three groups according to initial stage of joint infection (stage I: 21 patients, 22 joints; stage II: 43 patients, 44 joints; stage III: 12 patients, 12 joints). Causes of infection were: hematogenous dissemination in 54%, postoperative wound infection in 28% (17% after open, 11% after arthroscopic procedures). Other causes were: 10% intra-articular steroid injections, 3% diagnostic punctures, and 3% open traumatic injury of the joint. In 78% of the infected joints the causative organism could be identified: Staphylococcus aureus was the most common organism found (42%), followed by streptococci (15%), pneumococci (6%), Escherichia coli (4%), Staphylococcus epidermidis (3%), Borrelia burgdorferi (3%), and others in 5%. In the stage I group only one patient needed repeated arthroscopic irrigation, in the stage II group 52%, and in the stage III group 75%. Open revision for eradication of the infection was necessary in one joint with stage II and in two joints with stage III infection (3%). Two joints of the stage III group needed additional surgery after successful treatment of the infection. The combination of arthroscopic irrigation and systemic antibiotic therapy was able to cure 91% of the affected joints. Open revision was necessary in 4% of joints. The number of arthroscopic procedures and the efficacy of treatment depended on the initial stage of the infection. It is concluded that an arthroscopic staging of the initial joint infection has prognostic and therapeutic consequences.

Alcohol-induced decrease in uroporphyrinogen decarboxylase activity in rat liver and spleen.

Chronic alcohol consumption in rats leads to a decrease in uroporphyrinogen decarboxylase activity in liver and spleen, associated with a pathologic porphyrinuria. These findings show the toxic effect of alcohol in the biochemical pathogenesis of chronic hepatic porphyria. The results confirm experimentally the transition of symptomatic coproporphyrinuria to chronic hepatic porphyria as observed in man, and the progression of biochemical phases of chronic hepatic prophyria into the clinical phase, i.e., the development from latent to manifest stages under chronic alcohol ingestion.

[Clinical aspects of alcohol induced liver injury (author's transl)]. / Klinik alkoholbedingter leberschäden.

Chronic alcohol consumption results in early biochemical and ultrastructural alterations of the hepatocyte which in turn may lead to alcoholic fatty liver as well as alcoholic hepatitis and via the central hyaline sclerosis to fibrosis and cirrhosis of the liver. Already at the stage of the alcoholic fatty liver an isolated increase of serum gamma-glutamyltransferase activity can often be observed; it results from hepatic microsomal enzyme induction and may facilitate early recognition of alcoholic liver injury. To establish the diagnosis, however, a histological examination of the liver is necessary. The therapy of alcohol-induced liver injury is based upon an absolute alcohol abstinence since alcohol itself or one of its metabolites are hepatotoxic.