bluuebunny/crossref_metadata_2025 huggingface dataset:
The use of umbilical artery Doppler velocimetry in the monitoring of pregestational diabetic pregnancy
Authors: Wong S.‐F. , Chan F.‐Y. , Cincotta R. , Oats J. , McIntyre D.
Published: March 2003

Purpose:  To assess whether umbilical artery Doppler velocity waveform analysis can predict adverse perinatal outcomes for pregnancies complicated with pre‐existing diabetes mellitus (types 1 and 2 diabetes mellitus).

Methods:  All diabetic pregnancies (types 1 and 2) delivered at Mater Mothers' Hospital, Australia, between 1st January 1995 and 31st December 1999, were included. All pregnant diabetic women were monitored with umbilical artery Doppler velocimetry at 28, 32, 36, and 38 weeks gestation. Umbilical artery Doppler study was repeated on weekly basis for pregnancies complicated by macrosomia, polyhydramnios, or fetal growth restriction. Adverse perinatal outcome was defined as pregnancies with one or more of the following: small‐for‐gestational age (birth weight <10th centile), cesarean section for non‐reassuring cardiotocography, fetal acidemia at delivery (cord blood arterial pH < 7.2), 1‐min Apgar of ≤3, 5‐min Apgar of <7, hypoxic ischaemic encephalopathy, stillbirth and perinatal deaths. Abnormal umbilical artery Doppler index was defined as systolic/diastolic ratio of 95th centile or higher for gestation (including absent or reversed end‐diastolic flow). The incidence of adverse perinatal outcomes was compared between those with normal umbilical artery Doppler and those with elevated systolic/diastolic (S/D) ratio.

Results:  One hundred and four pregnancies had umbilical arterial Doppler studies performed during the study period. Twenty‐three pregnancies (22.1%) had elevated S/D ratio of the umbilical artery Doppler velocimetry. If the scans were performed within 2 weeks of delivery, 71% of pregnancy with abnormal umbilical Doppler study have adverse outcome. For umbilical artery Doppler studies performed within 1 week of delivery, the sensitivity was 35%; specificity was 94%; positive predictive value was 80%; and negative predictive value was 68%. However, only 30% of women with adverse perinatal outcomes had abnormal umbilical Doppler flow.

Conclusion:  Elevated umbilical arterial Doppler S/D ratio is associated with adverse perinatal outcomes. However, the majority of diabetic pregnancies with adverse perinatal outcomes have normal umbilical artery Doppler velocimetry. Thus, this could be a useful test for monitoring, but is not a good predictor of adverse perinatal outcomes.
Third trimester abdominal pregnancy
Authors: Salim A. , Handaya P. , Wiknjosastro G. H. , Karsono B.
Published: March 2003

Introduction:  Surviving of the fetus of the third trimester abdominal pregnancy is possible although very rare. The high fetal and maternal mortality rates is associated with it. We report four cases which succeed in having two living healthy babies. The subsequent problem is about the placenta which is left in the abdomen.

Methods:  Four women suspected of late abdominal pregnancy were referred to our center for further management. All of them underwent abdominal ultrasound and vaginal if necessary. Blood flow of the umbilical artery also studied. They were treated until the fetus is viable according to our pediatrician prior to be delivered abdominally.

Results:  From April 1994 until October 2000, we have four cases of third trimester abdominal pregnancy. Two cases of 30 and 32 weeks gestational age with fetal death intra‐abdominally. Another two cases of 33 and 31 weeks with living fetus intra‐abdominally and placenta implanted at the superior and posterior side of the uterus. Umbilical artery RIs were 0.67 and 0.71. The interval between time of admission till the delivery were 19 and 33 days. Female babies 2400 g Apgar score 9/10 and 1680 g Apgar score 6/8 for 1 and 5 min. They are growing and developing well except the first one has a slight club‐feet.

Conclusion:  We report four cases of third trimester abdominal pregnancies, two of which succeed in delivering healthy babies.
Three‐dimensional color power angiography of an aneurysm of the vein of Galen
Authors: Ximenes R. , Ximenes D. S. , Ximenes A. , Szejnfeld J. , Ajzen S. , D'Hippolitto G. , Goldman S. M. , Sandoval R.
Published: March 2003

Description of the case:  A 26‐year‐old, gravida 1, para 0, female. The first scan was at 16 weeks, with normal fetal biometry and development. At 25 weeks' gestation, a cystic area at the level of the biparietal‐diameter, measuring 25 mm of diameter, ventricles has normal sizes, the cystic area was interrogated with color Doppler and showed a typical ‘turbulent flow’. The transvaginal probe was performed for evaluation of the fetal brain. Color Doppler energy was used to evaluate the cystic area and their communications –‘angiography’, followed by tri‐dimensional reconstruction of the brain vessels, especially the venous drainage and the arterial communications. This pathology is referred as a complex arterio‐venous malformation (AVM). Antenatal MRI was performed to evaluate the central nervous system. The parents were counseled about the prognosis. At 34 weeks' gestation, the shunts of the arteriovenous malformation were more prominent, ventriculomegaly, tricuspid regurgitation and polyhydramnios.

Proof of diagnosis:  At 35–36 weeks' gestation, she delivered a female baby, weighing 2900 g, with Apgar score 4 and 8. The baby was transferred for the neonatal intensive care, but after 24 h died because of renal failure.

Relevance:  This report demonstrated that 3D color Doppler energy mode is useful in prenatal diagnosis and a more detailed angio‐architecture of the aneurysm of the vein of Galen, with a excellent correlation with MRI. We hope, in the near future this technique could guide the identification of the fetus at increased risk for intrauterine and neonatal cardiac failure and therefore poor prognosis.
Prevention of preterm labor by AIWA's score
Authors: Yoshitake H. , Koyama Y. , Fukuda J. , Uehira K. , Amiya S. , Yano S.
Published: March 2003

Purpose:  To elucidate the availability of ‘AIWA’s scoring' in prevention of preterm labor.

Patients:  We retrospectively studied the 6434 deliveries after 22 weeks of gestation, managed at AIWA‐Maternity Hospital from 1986 to 1990, and from 1995 to 2000.

• C‐stage: deliveries from 1986 to 1990: 1786 (control stage without AIWA's scoring);

• P‐stage: deliveries from 1995 to 1997: 2190 (prototype stage without AIWA's scoring);

• A‐stage: deliveries from 1998 to 2000: 2458 (applied stage with AIWA's scoring).

Nine twins and seven cases of pregnant mother transportation (MT) in (C) 1786, 25 twins and 3 MT in (P) 2190, and 17 twins, 2 triplets, 6 MT in (A) 2458, were involved, respectively.

Methods:  The ‘AIWA’s score' of risk assessment for premature delivery consists of cervical consistency, insertion resistance to external os of uterus by internal examination, and cervical length and funneling of internal os of uterus measured by transvaginal ultrasonography. The full AIWA's score is 12 point, which means extremely high risk of premature labor. On the other hand, 0 point means no risk of it. Then, P‐score (0–3) consists of the history of early delivery, abortion after 18 weeks of gestation, present multiplicity and so forth. AIWA's score + P‐score = AP‐score. (A) From 1998 to 2000, in case with AP‐score >8, before 26 weeks of gestation, patients had cervical cerclage if they wanted after severely informed consent. We compared some parameters between C‐ and A‐stage.

Results:  The rate of premature delivery declined (from 4.5 to 3.2% <37 weeks [P < 0.05]; from 2.5 to 1.3%, <36 weeks [P < 0.01]) in A‐stage using the risk assessment system. In all premature deliveries, those before 32 weeks of gestation declined from 15.2 to 2.6% (P < 0.01) in A‐stage. The rate of preterm PROM <34 weeks in all deliveries declined from 0.56 to 0.12% (P < 0.05), while the rate of preterm PROM in premature labor decreased from 12.7 to 3.9%, and the rate of emergency cervical cerclage also decreased from 13.5 to 1.2% (P < 0.05). In single baby delivery, the rate of cervical cerclage slightly decreased from 1.1 to 0.75% in nulliparous mother, however, it extremely increased from 2.7 to 5.3% in multipara.

Conclusions:  Prevention of preterm labor by prophylactic cervical cerclage using ‘AIWA’s score' would be useful to decrease premature deliveries and eventually to relieve the shortage of NICU beds in Japan. Preterm PROM before 34 weeks of gestation has been a problem for long years in perinatal management. Also, the success rate of emergency cervical cerclage has been poor. The rate of those two problems would declined using AIWA's scoring system. The rate of cervical cerclage in multipara was two times higher than that in control stage. The future issues is making of more appropriate indication and contraindication of cervical cerclage with special reference to patients QOL.
Pregnancy outcome following amnioinfusion in oligohydroamnios
Authors: Kim G. J. , Kim S. Y. , Son M. S.
Published: March 2003

Objective:  We sought to evaluate the fetal outcome following antepartum transabdominal amnioinfusion in oligohydroamanios except membrane rupture.

Materials and methods:  Twenty‐six transabdomial amnioinfusion were performed in 17 cases of singleton pregnancy with severe oligohydroamnios. We excluded premature membrane rupture cases. Transabdominal amnioinfusion was done with warmed lactate Ringer solution.

Results:  Infusion (mean volume 545 mL) of lactate Ringer's solution significantly increased the amniotic fluid index from 4 dm to 9.3 cm. Mean infusion time was 56.8 min The gestational weeks were prolonged significantly from 29.4 to 36.5 weeks. There was one case of fetal death. The mean birth weight was 2.6 kg and the mean Apgar score at 1, 5 min was 7.6 and 8.9. Uterine contractions after infusion were observed 3 in 21, no needle scratching marks detected at birth. No chorioamnionitis were observed.

Conclusions:  Our results show that antepartum transabdominal amnioinfusion is a relatively safe procedure, and it can significantly increase the amniotic fluid index and prolong the gesational age.
First‐trimester trisomy screening: nuchal translucency measurement training and quality assurance to correct and unify technique
Authors: Snijders R. J. M. , Thom E. A. , Zachary J. M. , Platt L. D. , Greene N. , Jackson L. G. , Sabbagha R. E. , Filkins K. , Silver R. K. , Hogge W. A. , Ginsberg N. A. , Beverly S. , Morgan P. , Blum K. , Chilis P. , Hill L. M. , Hecker J. , Wapner R. J.
Published: March 2003

Objective

To describe the process of training for measuring nuchal translucency at five clinical centers in North America and to evaluate methods of quality assurance and feedback

Design

Throughout a period of 18 months, the performance of sonographers in measuring fetal nuchal translucency was monitored using qualitative and quantitative methods of review. After 12 months, different approaches (written and personal feedback) were used to inform sonographers of technical aspects that needed to or could be improved.

Results

On initial qualitative review, discrepancies in judgment from different reviewers coincided with suboptimal magnification, failure to visualize the amniotic membrane and/or use of cross‐shaped calipers. At subsequent global review, 13 (29%) images of nuchal translucency measurements were considered unacceptable. Quantitative assessment revealed that, during the first part of the study, the means from four sonographers were significantly smaller and the mean from the fifth sonographer was significantly larger than expected on the basis of findings from The Fetal Medicine Foundation (P < 0.0001). Following feedback, sonographers who underestimated nuchal translucency and who received a written report only did not change measurements overall (P = 0.9759). In contrast, those who received additional intervention showed a marked difference (P < 0.0001).

Conclusions

Global qualitative review of images from one sonographer may be preferable to assessment of individual aspects of images. Results from global qualitative review correspond well with findings from quantitative analysis, indicating that the latter can be applied for ongoing audit. Observation of divergent results should prompt extensive personal feedback, rather than a written report, to prevent sonographers from settling in their own, inappropriate technique. Copyright © 2002 ISUOG
Undescended testicle and a meconium‐filled hemiscrotum: prenatal ultrasound appearance
Authors: Gililland A. , Carlan S. J. , Greenbaum L. D. , Levy M. C. , Rich M. A.
Published: March 2003

We report a case of a meconium‐filled hemiscrotum detected by prenatal ultrasound and misdiagnosed as in‐utero testicular torsion. Over the 2 months that the mass was followed, the ultrasound characteristics and size changed significantly. Imaging immediately after birth and early surgical treatment resulted in a favorable outcome. Copyright © 2000 International Society of Ultrasound in Obstetrics and Gynecology
Assessment of uterine artery blood flow in normal first‐trimester pregnancies and in those complicated by uterine bleeding
Authors: Pellizzari P. , Pozzan C. , Marchiori S. , Zen T. , Gangemi M.
Published: March 2003

Objective

To compare uterine artery blood flow in normal first‐trimester pregnancies with those complicated by uterine bleeding.

Methods

Uterine artery blood flow was investigated by transvaginal color Doppler in 46 pregnant women affected by uterine bleeding and in a control group of 35 women with normal intrauterine pregnancy. Gestational age ranged from the 6th to the 12th week. Three blood flow values were calculated, the pulsatility index, the resistance index and the peak systolic velocity. Results were compared between the two groups.

Results

Of the 46 patients affected by uterine bleeding, 18 had an incomplete miscarriage, eight had a blighted ovum, five had a missed miscarriage and 15 continued their pregnancy until term and delivered liveborn infants. No significant differences were found in any of the three vascular indices between the normal and the pathological groups of patients. Uterine artery pulsatility and resistance indices decreased with gestational age in both normal and abnormal pregnancies but this change was not statistically significant. The peak systolic velocity significantly increased with gestational age in the control group but not in the pathological group. In patients with a retroplacental hematoma, uterine vascular resistance appeared higher than in those without a hematoma, while the peak systolic velocity showed no difference between the two groups.

Conclusion

Doppler analysis of the uterine artery blood flow is unlikely to have a clinical role in the management of early pregnancies complicated by uterine bleeding. Copyright © 2002 ISUOG
Serial translabial sonographic measurement of cervical dimensions between 24 and 34 weeks' gestation in pregnant Thai women
Authors: Liabsuetrakul T. , Suntharasaj T. , Suwanrath C. , Leetanaporn R. , Rattanaprueksachart R. , Tuntiseranee P.
Published: March 2003

Objective

To assess serial changes of cervical dimensions in pregnant Thai women between 24 and 34 weeks' gestation by translabial sonography.

Methods

A longitudinal study of cervical dimensions obtained by translabial sonography at 24, 28, 30, 32, and 34 weeks' gestation in 144 women was conducted. The gestational age at labor was recorded and women were defined as having preterm labor or term labor according to whether there was onset of true labor pain before or after 37 completed weeks, respectively. Cervical changes over time were analyzed by repeated anova. The associations between cervical dimensions and gestational age, parity and prepregnancy body mass index were calculated by multiple linear regression analysis.

Results

Cervical length decreased whereas cervical width increased as gestational age advanced. Cervical length and width in women with term labor, but only cervical length in women with preterm labor, changed significantly throughout the period of 24–34 weeks' gestation (P < 0.01). The cervix was significantly longer in parous women and in women with a body mass index of more than 26 kg/m2, but was shorter in women of advanced gestational age. The cervix was significantly wider in parous women and in those of advanced gestational age. Weekly crude rate, adjusted for parity and prepregnancy body mass index, of both cervical length shortening and cervical width widening was 0.4 mm in women with term labor. Women with preterm labor had cervical shortening of 0.5 mm per week.

Conclusions

Gestational age, parity and prepregnancy body mass index are significantly associated with the dynamic changes of cervical length and width in Thai women. These factors should be considered when assessing normal values of cervical dimensions and for predicting the risk of preterm delivery.
Gestational sac diameter in very early pregnancy as a predictor of fetal outcome
Authors: Oh J. S. , Wright G. , Coulam C. B.
Published: March 2003

Objective

To determine whether transvaginal sonographic measurement of gestational sac diameter in pregnancies 28–42 days from the last menstrual period can predict whether a pregnancy results in a normal term birth or a spontaneous miscarriage.

Design

Gestational sac diameter was measured during the 4th and 5th weeks of gestation from the last menstrual period in 67 women who had a total of 102 ultrasound scans. These pregnancies were followed until one of two outcomes occurred: term gestation (n = 32) or spontaneous miscarriage (n = 35). Gestational sac diameter as a function of gestational age was compared in each of the groups.

Results

The mean diameter of the gestational sac at 28–35 days from the last menstrual period among normal pregnancies did not differ significantly from that in those that subsequently miscarried (2.6 mm vs. 2.7 mm; P = 1.00). In pregnancies 36–42 days from the last menstrual period, the mean sac diameter was significantly different between the two groups (normal group, mean sac diameter, 8.2 mm and miscarriage group, mean sac diameter, 4.5 mm; P < 0.001).

Conclusion

There is no difference in gestational sac diameter at 28–35 days from the last menstrual period in normal and abnormal pregnancies. However, smaller than expected sac diameter in pregnancies 36–42 days from the last menstrual period is predictive of spontaneous miscarriage. Copyright © 2002 International Society of Ultrasound in Obstetrics and Gynecology
Evaluation of the fetal coronary circulation
Authors: Baschat A. A. , Gembruch U.
Published: March 2003

Prenatal ultrasound today allows the detailed study of small caliber vascular beds including the fetal coronary arteries and the coronary sinus. The coronary circulation is unique because of its critical role in myocardial metabolism and function and its ability to adapt in many fetal conditions. The ultrasound examination techniques for the evaluation of the fetal coronary circulation are presented. Evaluation of the coronary arteries is primarily achieved by color flow imaging and pulsed wave Doppler. Conditions such as fetal growth restriction, anemia, ductus arteriosus constriction and bradycardia are associated with evidence of enhanced coronary blood flow. These findings suggest that short‐term autoregulation and long‐term alterations in myocardial flow reserve are present in the human fetus. At present, examination of coronary sinus blood flow has limited clinical utility, while increases of the coronary sinus diameter or attenuation of coronary sinus dynamics may provide useful markers of abnormalities of central venous drainage. Abnormal vascular connections between the coronary arteries and the ventricular cavities may be observed in outflow tract obstructive cardiac lesions. In these conditions prenatal detection of coronary fistulae may have a potential impact on outcome and therefore counseling and perinatal management. Copyright © 2002 International Society of Ultrasound in Obstetrics and Gynecology
Ultrasound estimation of amniotic fluid volume using the largest vertical pocket containing umbilical cord: measure to or through the cord?
Authors: Magann E. F. , Chauhan S. P. , Washington W. , Whitworth N. S. , Martin J. N. , Morrison J. C.
Published: March 2003

Objectives

The purpose of this investigation was to determine the preferable method, either measuring to the umbilical cord or through the umbilical cord to the base of the pocket, of ultrasonically estimating amniotic fluid volume.

Subject and methods

This was a prospective study carried out in singleton pregnancies undergoing a third‐trimester amniocentesis. The amniotic fluid index (AFI) and single deepest pocket (SDP) were measured prior to amniocentesis. If measured spaces contained umbilical cord, measurements were made to and through the cord. Actual amniotic fluid volume was determined by the dye‐dilution technique.

Results

One‐hundred pregnancies were evaluated. Low dye‐determined volume was identified in a significantly greater number of pregnancies using the AFI to the cord (7/28, 25%) compared to through the cord (2/28, 7%) (P = 0.025). The SDP technique to the cord was superior in low volumes (2/28, 7%) vs. (0/28, 0%) through the cord (although statistical significance could not be determined because there were no low through‐the‐cord measurements).

Conclusions

For the detection of low amniotic fluid volumes, the AFI to the cord is better than through the cord. Measurement to the cord and through the cord had similar accuracy for both the AFI and SDP techniques in normal and high dye‐determined amniotic fluid volumes. Copyright © 2002 International Society of Ultrasound in Obstetrics and Gynecology
Transvaginal ultrasonography in predicting placenta previa at delivery: a longitudinal study
Authors: Mustafá S. A. , Brizot M. L. , Carvalho M. H. B. , Watanabe L. , Kahhale S. , Zugaib M.
Published: March 2003

Objectives

To determine the extent of overlapping of the internal cervical os by the lower placental edge at 11–14 weeks' gestation which best predicts placenta previa at term.

Patients and methods

This was a prospective study initially involving 381 singleton pregnancies with a live fetus at 11–14 weeks attending for routine antenatal care. The distance between the lower placental edge and the internal cervical os was longitudinally evaluated by transvaginal ultrasound examination at 11–14 weeks', 20–24 weeks', and 30–34 weeks' gestation. The first 203 cases were selected at random (first phase) and after this period only cases with the lower placental edge reaching and/or overlapping the internal cervical os were followed up (n = 170, second phase). Thus a total of 373 cases were analyzed, 351 of whom were examined in all three trimesters. Multiple regression analysis was used to estimate the probability of predicting placenta previa at term using the overlap of the lower placental edge over the internal cervical os in the first trimester of pregnancy.

Results

A change in the relative position of the placenta (placental migration) was observed in all 351 cases examined in the three trimesters of pregnancy. In the general population, represented by the 203 cases (first phase), the incidence of placenta previa at 11–14 weeks' gestation was 42.3% (86/203), at 20–24 weeks' 3.9% (8/203) and at term 1.9% (4/203). A total of 18 cases of placenta previa and 17 cases of marginal placenta were observed at term. It was estimated that when the lower placental edge overlaps the internal cervical os by 23 mm at 11–14 weeks the probability of placenta previa at term is 8% with a sensitivity of 83.3% and specificity of 86.1%.

Conclusion

The present study establishes the probability of placenta previa at term depending on the relationship of the lower placental edge to the internal cervical os at 11–14 weeks. Copyright © 2002 International Society of Ultrasound in Obstetrics and Gynecology
Otx genes in evolution: are they involved in instructing the vertebrate brain morphology?
Authors: ACAMPORA DARIO , BOYL PIETRO PILO , MARTINEZ‐BARBERA JUAN PEDRO , ANNINO ALESSANDRO , SIGNORE MASSIMO , SIMEONE ANTONIO
Published: March 2003

abstract

Previous mouse models have indicated that Otx1 and Otx2 play an important role in brain and sense organ development and, together with the Drosophila orthodenticle (otd) gene, they share a high degree of reciprocal functional equivalence. Interestingly, mouse models replacing the same region of the Otx2 locus with Otx1, otd or lacZ genes have revealed the existence of a differential post‐transcriptional control between the visceral endoderm (VE) and epiblast cells. Indeed Otx1, otd or lacZ mRNA were transcribed in both tissues but translated only in the VE. Embryos lacking OTX1 or OTD proteins in the epiblast and derived tissues, such as the neuroectoderm and axial mesendoderm (AME), fail to maintain the anterior identity and result in a headless phenotype. This finding leads us to hypothesise that, during evolution, the specification of the vertebrate‐type brain may have required epiblast cells to translate Otx2 mRNA in order to establish maintenance properties. The establishment of this regulatory control might have been reflected into a remarkable reorganisation of the rostral CNS architecture and might have represented an important event in the evolution of the vertebrate head. Current data suggest that the Otx2 replaced region and in particular the 3′ untranslated region (UTR), may contain regulatory element(s) necessary to translate and/or stabilise Otx2 mRNA in epiblast and its derivatives.
Distribution of NADPH‐diaphorase and nitric oxide synthase‐containing neurons in the intramural ganglia of guinea pig urinary bladder
Authors: ZHOU Y. , TAN C. K. , LING E. A.
Published: March 2003

The cell population and distribution of NADPH‐diaphorase positive and NOS immunoreactive intramural ganglion cells were examined on stretched whole‐mount preparations of the guinea pig urinary bladder which was divided into 3 regions: base, body and dome. The results showed that the highest frequency both of NADPH‐d and NOS positive neurons was observed in the bladder base. Cell counts in the whole bladder showed that the number of NADPH‐d positive neurons was much more than that of NOS immunoreactive neurons. Using neuron specific enolase (NSE) positive neurons as a reference (100%), NADPH‐d positive neurons accounted for 84% while NOS immunoreactive neurons only made up 45% of the total neuronal population. These results, along with previous studies on the function of nitric oxide, suggest that nitric oxide may be involved in the relaxation activity in the bladder base during micturition. The significant difference in the number of NADPH‐d positive and NOS immunoreactive neurons suggests that the localisation of one enzyme does not necessarily reflect the presence of the other.
Abnormal craniofacial growth and early mandibular osteoarthritis in mice harbouring a mutant type II collagen transgene
Authors: RINTALA MARJO , METSÄRANTA MARJO , SÄÄMÄNEN ANNA‐MARJA , VUORIO EERO , RÖNNING OLLI
Published: March 2003

Skull morphology and histology in the heterozygous offspring of a transgenic founder mouse Del1, harbouring 6 copies of deletion mutation in Col2a1 gene, were compared with those in normal siblings. On visual observation and roentgenocephalometric examination the heads of heterozygous Del1 mice were smaller than normal. Histologically the sizes of cartilaginous structures of the cranial base were reduced. Severe defects were seen in the temporomandibular joint as progressive osteoarthritic lesions. These observations elucidate the relationship between the genotype and phenotype and demonstrate that heterozygous Del1 mice are a useful model for studies on a genetic disturbance where ‘clinical’ manifestations are not evident until adult age.
Sensory innervation of the cat knee articular capsule and cruciate ligament visualised using anterogradely transported wheat germ agglutinin–horseradish peroxidase
Authors: MADEY STEVEN M. , COLE KELLY J. , BRAND RICHARD A.
Published: March 2003

Wheat germ agglutinin–horseradish peroxidase conjugate (WGA–HRP) was injected into the dorsal root ganglia (L5–S1) of the cat and used as an anterograde tracer substance for intra‐axonal labelling of peripheral nerve endings in joint capsule and cranial (anterior) cruciate ligament (CCL). We believed that the high specificity of WGA–HRP for neural tissue along with the high visibility of its reaction product could help resolve controversies concerning the sensory innervation of the cruciate ligaments. Substantial amounts of WGA–HRP were transported in tibial nerve axons to the level of the knee. However, using standard HRP histochemistry we found that the capsular tissue and ligament synovia disintegrated during the incubation reaction. This problem was avoided by air drying the tissue slices on glass slides prior to reaction. Abundant labelling occurred in the posterior capsule with dense filling of axons and terminal endings. Sensory endings displayed features consistent with Ruffini endings and pacinian corpuscles. Sensory endings were located throughout the CCL in its sagittal plane, in the subsynovial layers and between collagen fascicles. In each CCL we observed 5–17 ovoid and elongated endings with dense terminal arborisations. These endings were between 100 and 150 μm long, were encapsulated, and gave rise to 1 or 2 axons. Large (up to 1.5 mm in maximum extent) elongated regions of dense, inhomogeneous labelling were found in the body of several CCLs. These resembled Golgi tendon‐like endings, with the exception of their large size. We conclude that anterograde transport of HRP to the knee is a useful technique for labelling mechanoreceptors and axons in knee tissue. However, recently developed immunohistochemical analysis of peripheral tissue using protein gene product 9.5 appears to be the method of choice and should be employed for further study of human and animal cruciate ligament innervation.
Correspondence: Nerve–muscle specificity
Authors: KIDA MASAHIKO Y.
Published: March 2003

A correspondence item entitled ‘A warning against revival of the classic tenets of gross anatomy related to nerve–muscle specificity’ was recently published in the Journal of Anatomy (Shinohara, 1996a). The present correspondent fully agrees with some aspects of his opinion, in particular, the 3 laws about applications which he described, and he also appreciates his approach to the argument based on the results of embryology and experimentation. However, his denial of morphological interpretations based on the theory of nerve–muscle specificity may be due to an incomplete understanding of the current status of the theory.
The effects of ageing on wound healing: immunolocalisation of growth factors and their receptors in a murine incisional model
Authors: ASHCROFT GILLIAN S. , HORAN MICHAEL A. , FERGUSON MARK W. J.
Published: March 2003

A number of reports suggest that the process of ageing impairs wound repair and that strategies to manipulate the age‐related wound healing environment are necessary in order to stimulate repair. The process of cutaneous wound repair is controlled by growth factors in an autocrine and paracrine fashion: it is therefore surprising that the localisation of specific growth factors and their receptors has not been documented in wound healing with respect to chronological age. In this study the temporal profile of growth factor and receptor immunostaining was assessed within acute incisional wounds in an ageing mouse colony. A delay in appearance of platelet derived growth factor (PDGF) A and B isoforms, and PDGF‐α and ‐β receptors was evident with increasing animal age, paralleled by a similar finding for epidermal growth factor (EGF) and EGF receptor. Transforming growth factor (TGF)‐7beta;1 and 2 isoforms were increased at all time points in the wounds of younger animals, but the TGF‐β3 isoform increased in intensity from d 7 postwounding in the old mice wounds, and basic fibroblast growth factor (bFGF) from d 14. The quantity and distribution patterns of the various growth factors and their receptors may explain the age‐related differences in wound healing speed and quality, and possibly suggest new therapeutic targets for manipulating wound healing in the aged.
Changes in the surface of the superior articular joint from the lower thoracic to the upper lumbar vertebrae
Authors: SHINOHARA HARAMUCHI
Published: March 2003

Thirty‐two human vertebral columns were selected from the Kanazawa Collection at the University of Kanazawa, Japan. The superior articular joint surface was categorised into the thoracic type and the lumbar type, and the pattern of the change from one type to the other in the lower thoracic and upper lumbar region was examined. In 21 of 32 cases (66%), the change from the thoracic to the lumbar type occurred over 2 vertebral segments, either between the 12th thoracic and 1st lumbar vertebrae (44%) or between the 11th and 12th thoracic vertebrae (22%). In the remaining 11 cases (34%), the change occurred over 3 vertebral segments, with a transitional type of articular surface. The change from the thoracic to lumbar type of articular surface has been believed to occur over 2 vertebral segments, but occurs over 3 segments in as many as 34% of the articular surfaces.
Increase in immunoreactivity for endothelin‐1 in blood vessels of rat liver metastases: experimental sarcoma and carcinoma
Authors: LOESCH A. , TURMAINE M. , LOIZIDOU M. , CROWE R. , ASHRAF S. , TAYLOR I. , BURNSTOCK G.
Published: March 2003

Using electron immunocytochemistry, blood vessels in the normal rat liver and in 2 different animal models of liver metastases: (1) Hooded Lister rat with MC28 tumour, a sarcoma, and (2) nude rat with HT29 tumour, a carcinoma, were investigated for the presence of endothelin‐1. In the normal livers, small subpopulations of vascular endothelial cells displayed discrete immunoreactivity for endothelin‐1. In the livers with malignant tumours, there was a substantial increase in endothelin‐1‐immunoreactive endothelial cells in vessels located at the tumour periphery. In the controls, antibody to endothelin‐1 also labelled sporadically some fibroblast/fibroblast‐like cells associated with the blood vessels. In contrast, intense immunoreactivity for endothelin‐1 was frequently associated with the tumour cells and/or fibroblast cells in both types of tumour examined.
Modulation of dye‐coupling and proliferation in cultured rat thymic epithelium by factors involved in thymulin secretion
Authors: HEAD G. M. , MENTLEIN R. , KRANZ A. , DOWNING J. E. G. , KENDALL M. D.
Published: March 2003

Cultures of rat thymic epithelium were used to measure the effect of thymulin secretagogues on dye‐coupling and proliferation. Dye‐coupling was assessed after the injection of lucifer yellow dextran which cannot permeate the connexin pore of gap junctions and the smaller, permeant cascade blue. In addition to gap junctional communication, larger intercellular bridges were demonstrated by the transfer of lucifer yellow dextran between cells. The extent of intercellular communication was found to be influenced by both cell density and the number of passages. In control cultures, intercellular communication was reduced in cell groups of low (<20 cells/group) or high cell densities (>100 cells/group) compared with groups of 20–60 cells. The highest coupling indices were found in subcultures 20–30. Taking these factors into account, significant decreases in coupling index were observed after pretreatment of test cultures with factors known to influence the secretion of thymulin (5 U/ml interleukin 1 (α and β), 1 μM progesterone, 1 μM oestrogen, 1 μM testosterone, 1 ng/ml adrenocorticotropic hormone, 100 nm rat growth hormone) but 7.5 ng/ml thymulin had no effect on dye‐coupling. The nonspecific gap junction uncoupler, octanol, abolished dye‐coupling. Cellular proliferation, as measured by the uptake of tritiated thymidine, showed that the same factors that reduced coupling also increased proliferation. None of these factors affected the number of multinucleate cells present, except interleukin‐1β which caused a significant reduction in the average number of nuclei per cell. Thus rat thymic epithelium in vitro provides a model for the study of the direct action of factors on cells of the thymic microenvironment.
Proliferative activity of preovulatory follicles and newly formed corpora lutea in cycling rats from late prooestrus to early oestrus
Authors: GAYTÁN FRANCISCO , BELLIDO CARMEN , MORALES CONCEPCIÓN , AGUILAR ENRIQUE , SÁNCHEZ‐CRIADO JOSÉ EUGENIO
Published: March 2003

Ovaries from adult cycling rats were studied from 1600 h on the day of prooestrus to 0700 h on the day of oestrus in order to relate the cyclic hormonal changes to the proliferative activity of preovulatory and postovulatory (i.e. newly‐formed corpora lutea) follicles. Proliferative activity was studied by the immunohistochemical demonstration of DNA‐incorporated 5‐bromodeoxyuridine (BrdU). The proliferative activity of granulosa cells (GC) in large preovulatory follicles showed a centripetal pattern and decreased during prooestrus, reaching a minimum at 2100 h. However, a proliferative wave was found in the GC of preovulatory follicles at 0200 h on the day of oestrus and in those of newly‐formed corpora lutea at 0700 h on the day of oestrus. These results suggest that the granulosa cells of preovulatory follicles show maturational changes that followed a different pattern, depending on their location within the follicle, and that the proliferative wave found from 0200 to 0700 h on oestrus is important for the establishment of the number of steroidogenic cells in the cyclic corpus luteum.
Effect of hypophysectomy on endocrine cell types in rat gastrointestinal mucosa
Authors: PORTELA‐GOMES G. M. , ALBUQUERQUE J. P.‐G. , FERRA M. A. , GRIMELIUS L.
Published: March 2003

The effect of hypophysectomy on the gastrointestinal tract was studied in the rat 8 wk after operation, particularly regarding the frequency and distribution of serotonin, somatostatin and gastrin‐immunoreactive cells. Body weight, the length of the intestine and the thickness of the mucosa of the antrum and small intestine were all reduced in the hypophysectomised rats compared with sham‐operated and untreated controls. In the hypophysectomised animals the serotonin‐immunoreactive cells were fewer in the antrum and caecum, whereas they were more numerous in the proximal large intestine. There were fewer gastrin‐immunoreactive cells in the antrum, while the somatostatin‐immunoreactive cells were more numerous in the antrum and caecum. The significant influence of hypophysectomy on the gastrointestinal tract could be direct, but could also be associated with the marked effect of pituitary deficiency on endocrine cells, known to exert both trophic and antitrophic actions. However, it could also be an indirect effect on metabolism, resulting in lower food intake, other endocrine cell systems, and growth factors.
Encapsulated Ruffini‐like endings in human lumbar facet joints
Authors: VANDENABEELE F. , CREEMERS J. , LAMBRICHTS I. , LIPPENS P. , JANS M.
Published: March 2003

The innervation of the human lumbar facet joint capsule was studied by light and electron microscopy. Small numbers of encapsulated corpuscular endings were identified in the dense fibrous layer. Clusters of 2 types of endings were found: small cylindrical corpuscles (type 1) and large fusiform corpuscles (type 2). The corpuscles were classified structurally as Ruffini‐type endings. The 1st type was predominant and characterised by a compartmentalised receptor complex, a thin perineurial capsule and a narrow subcapsular space. The 2nd type was characterised by a thicker perineurial capsule, a ‘spindle‐like’ receptive complex, and an extensive subcapsular space with capillaries and concentrically oriented fibroblast‐like cells. Both types of endings were innervated mainly by thinly myelinated group III (A delta) and unmyelinated group IV (C) nerve fibres that branched and terminated in the receptor complex. Their sensory endings were intimately related to the collagen fibre bundles as multiple enlarged axonal segments (‘beads’) with ultrastructural features which were characteristic of receptive sites: an accumulation of mitochondria and vesicles, and ‘bare’ areas of axolemma lacking a Schwann cell investment but covered by a thin basal lamina. Some beads in the 2nd type of ending contained granular vesicles, 30–60 mm in diameter, resembling sympathetic nerve endings. Small diameter collagen fibrils situated within multilayered basal laminae were found among the multiple receptive sites in the receptive complex in both types of ending. Their possible functional significance in mechanoreception is discussed. Particular attention has been given to their apparent variable orientation to the mechanoreceptive site.
Expression of NADPH‐diaphorase and nitric oxide synthase in lumbosacral motoneurons after knee joint immobilisation in the guinea pig
Authors: HE X. H. , TAY S. S. W. , LING E. A.
Published: March 2003

The expression of nicotinamide adenine dinucleotide phosphate‐diaphorase (NADPH‐d) and nitric oxide synthase (NOS) in spinal ventral horn neurons was studied in the guinea pig after right knee joint immobilisation (RKJI). At 1 wk after RKJI, neurons in the ipsilateral ventral horn from L4 to S1 segments showed a moderate reactivity for NADPH‐d staining. At 2 wk, NADPH‐d labelled neurons were also observed in the contralateral ventral horn. Ipsilateral NOS immunoreactive cells were not detectable until wk 2. The intensity of NADPH‐d and NOS labelled neurons in the bilateral ventral horns was sustained, peaking at the 4th wk after RKJI. In guinea pigs subjected to 4 wk of RKJI and subsequently released from the immobilisation for 2 and 4 wk, NADPH‐d and NOS reactivity in ventral horn neurons diminished. The expression of NADPH‐d positive neurons differed from that of NOS labelled neurons in terms of time interval, cell number and staining intensity, the latter being later, fewer and weaker. It is suggested that the induction and upregulation of NADPH‐d and NOS are attributable to reduced activity of muscles acting on the knee joint after RKJI; the changes are reversible. It is speculated that increased levels of NO production are involved in protective mechanisms against possible neuronal degeneration as a consequence of target dysfunction.
Analysis of interdigital spaces during mouse limb development at intervals following amniotic sac puncture
Authors: CHANG H.‐H. , TSE Y. , KAUFMAN M. H.
Published: March 2003

A spectrum of limb abnormalities ranging from adactyly, syndactyly, acrosyndactyly to nail hypoplasia was encountered in mouse embryos subjected to amniotic sac puncture at the corresponding gestational stage when human chorionic villus sampling (cvs) would normally be performed clinically. Previous skeletal studies revealed that, apart from the occasional incidence of fusion of 2 distal phalanges, syndactyly usually only affected the soft tissues within the interdigital spaces. A similar situation was also observed in cases of adactyly; while the skeletal elements of the digits were present, the soft tissues in the interdigital spaces failed to separate. A transient period of bradycardia is induced, possibly secondary to compression of the embryo by the extraembryonic membranes and uterine muscles following amniotic sac puncture. These factors, we believe, produce temporary hypoxia/ischaemia of the distal extremities, and may lead to the modification of the interdigital mesenchymal tissues within the autopods. In order to investigate the mechanism(s) underlying soft tissue syndactyly, limbs recovered at 0.5, 4, 8, 12, 24, or 36 h following amniotic sac puncture (ASP) were examined histologically. Vascular disruption in the form of localised areas of haemorrhage, vascular dilatation and congestion and the presence of fluid‐filled cavities occurred in relation to the marginal vein and vascular plexus in the interdigital spaces. It is hypothesised that this interfered with the normal equilibrium of the preset programs of mitosis/cell death and apoptosis within the mesenchymal cells of the interdigital spaces. Apoptosis in these areas was inhibited in the majority of the experimental limbs analysed 4 h after ASP. Instead of undergoing necrosis/apoptosis, increased mitotic activity was usually observed from 8 h following ASP at the sites where apoptosis would normally be expected to be seen. The aberrant fate of the interdigital mesenchyme following ASP and the underlying mechanism(s) involved are discussed, as is the critical importance of an adequate vascular supply to the interdigital spaces during the morphogenesis of the autopod. We believe that this report contributes to understanding the mechanism(s) which lead to syndactyly following ASP, and the limb defects occasionally seen following cvs when this is undertaken during early gestation.
Pathways of interstitial fluid and lymph flow in the liver acinus of the sheep and mouse
Authors: HEATH TREVOR , LOWDEN STEWART
Published: March 2003

In the acinus of the sheep and mouse liver, lymphatic vessels are restricted to the portal tracts. Vessels less than about 25 μm across form a network around portal venules, and are closely associated with the limiting plate of hepatocytes. The perisinusoidal space of Disse is continuous with the interstitial space of the portal tracts at the origin of the sinusoids. It seems likely that excess interstitial fluid derived from the sinusoids flows along the perisinusoidal space of Disse to enter the portal tracts near the portal venules, and then enters the small lymphatics which lie adjacent to those venules. It then enters the larger vessels, which are adjacent to hepatic arterioles and bile ductules.
A technique for establishing the identity of ‘isolated’ fossil hominin limb bones
Authors: WOOD BERNARD , AIELLO LESLIE , WOOD CHRISTOPHER , KEY CATHY
Published: March 2003

Associated skeletons, which are specimens preserving more than one body part from the same individual, are especially important for taxonomic and functional analyses. This study concentrates on the subset of associated skeletons which preserve the reciprocal surfaces of a joint. It uses laser scanning to explore whether the shapes of the reciprocal surfaces of a joint of an individual are significantly more congruent than the surfaces of randomly‐matched pairings taken from the same species. Laser scanning was used to capture the distal articular surface of the left tibia of OH35 and the trochlear articular surface of the talus of OH8, both from Bed I, Olduvai Gorge, Tanzania. The degree of congruency between those articular surfaces was tested against the congruency of the talocrural joint of AL 288‐1 (Australopithecus afarensis), and the congruency of both associated and randomly‐matched talocrural joints of modern humans, chimpanzees and gorillas. The results suggest that OH35 and OH8 do not come from the same individual and may not come from the same species. Although this analysis leaves open the taxonomic affinity of OH35, it demonstrates the potential of laser scanning for capturing 3D data in palaeoanthropology. It also demonstrates the potential for using the relative congruency of reciprocal joint surfaces as a test of the likelihood that isolated limb bones are components of a single individual.