Identification of tyrosine kinases expressed in the male mouse gubernaculum during development.
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The gubernaculum is a mesenchymal tissue that connects the gonads to the inguinal abdominal wall in the mammalian embryo. During gestation in the male, differential development of the gubernaculum and regression of the cranial suspensory ligament coordinate the first phase of testicular descent. As many as 1-3% newborn boys show impaired testicular descent, in part due to problems in gubernacular development. Little is known about the signaling molecules and cascades that are required for the development and differentiation of the gubernaculum. Protein tyrosine kinases comprise a large class of proteins that play important roles in proliferation, differentiation, and many aspects of cell-cell signaling in tissues. To date, no information on the existence of members of tyrosine kinase family in gubernaculum is available. We used a reverse transcription-polymerase chain reaction approach to identify 25 individual members of cytoplasmic and receptor tyrosine kinase classes in the developing male gubernaculum. The analysis of cellular distribution suggests that each tyrosine kinase examined may play a unique role in gubernacular development and differentiation. (+info)
Bilateral spontaneous dislocation of intraocular lenses within the capsular bag in a retinitis pigmentosa patient.
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A 45-year-old man with retinitis pigmentosa (RP), who had undergone uneventful extracapsular cataract extraction (ECCE) in his right eye eight years previously, and phacoemulsification in his left eye six years previously, had spontaneously dislocated intraocular lenses (IOL) within the capsular bag in both eyes one month apart. We removed the dislocated IOLs, and performed anterior vitrectomy and scleral fixation of the new IOLs. Mild contraction of the capsular bags and uneven distribution of the zonular remnants' clumps along the equator of the capsules were found by scanning electron microscopic (SEM) examination. In this study, we propose the correlation between RP and zonular weakness. To our knowledge, this is the first case report of bilateral spontaneous dislocation of IOLs within the capsular bag of an RP patient. (+info)
Qualitative effect of zonular tension on freshly extracted intact human crystalline lenses: implications for the mechanism of accommodation.
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PURPOSE: To determine the topographic effects of zonular tension on the anterior surface of the human crystalline lens. METHODS: Real-time topography of the anterior surface of seven fully relaxed, freshly extracted intact, clear, human crystalline lenses aged 3, 17, 45, 54, 54, 56, and 56 years was qualitatively obtained before, during, and after the application of zonular traction. Zonular traction was applied manually either by grasping a group of zonules 180 degrees apart with tying forceps (three lenses), or with micrometers by clamping four portions of the ciliary body that were 90 degrees apart (four lenses). RESULTS: Zonular tension began with the lenses in the fully relaxed, baseline state. As zonular tension was increased across one meridian of all seven lenses, the center of the anterior surface steepened while the periphery of the anterior surface flattened across that meridian of traction. When the tension was reduced across that meridian of traction, the center of the lens flattened while the periphery steepened in that meridian. Four-point zonular traction applied 90 degrees apart produced symmetrical central steepening (four lenses). Reduction of zonular tension across both orthogonal meridians caused symmetrical central flattening. CONCLUSIONS: These observations reveal that when zonular tension is applied to the fully relaxed lens, the center steepens and its periphery flattens in the meridian (or meridians) in which zonular tension is applied. The reverse of this process demonstrates that as tension is reduced, the center of the lens flattens while the periphery steepens either in the meridian of relaxation or symmetrically when zonular tension is released from two orthogonal meridians. These results are opposite to what would have been predicted on the basis of Helmholtz's theory of accommodation. (+info)
Abdominal pain in long distance runners: case report and analysis of the literature.
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Abdominal pain is a common complaint among participants in endurance sports. It may be severe, recurrent, and resistant to treatment. There is no direct evidence of the cause of this phenomenon. This report is of a long distance runner who had severe pain in the upper right abdominal quadrant during strenuous exertion. The symptom had been present for several years and did not respond to conservative treatment. Laparoscopy showed congenital supernumerary ligaments binding the gallbladder to the abdominal wall. The complaint resolved after cholecystectomy and resection of adhesions. There was evidence of chronic cholecystitis on histopathological examination. Two years after the operation, he remains free of symptoms. The differential diagnosis of abdominal pain in athletes is discussed. (+info)
Ossification of the ligamentum flavum induced by bone morphogenetic protein. An experimental study in mice.
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Ossification of the ligamentum flavum and secondary spinal-cord compression were produced experimentally in mice by implanting bone morphogenetic protein (BMP) in the lumbar extradural space. The ligamentum flavum became hypertrophied and ossified, and protruded into the spinal canal. The thickness of the ossified ligament increased gradually with time, leading to compression and deformation of the spinal cord which showed various degrees of degeneration. Demyelination occurred in the posterior and lateral white columns and neuronal loss or chromatolysis in the grey matter. The pathological findings in the experimental animals closely resemble those found in the human disease and suggest that BMP may be a causative factor of ossification of the ligamentum flavum in man. This experimental model may be useful for the study of myelopathy caused by gradual spinal-cord compression. (+info)
The gubernaculum in testicular descent and cryptorchidism.
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The gubernaculum plays an essential role in the complex mechanism of testicular descent and inguinal hernia closure. Understanding this complex developmental process is gradually allowing us insight into how to regulate normal descent and also treat maldescended testes. (+info)
Adipose tissue at entheses: the rheumatological implications of its distribution. A potential site of pain and stress dissipation?
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OBJECTIVES: To describe the distribution of adipose tissue within and adjacent to entheses in order to assess its functional significance at attachment sites. METHODS: Entheses were removed from 29 different sites in the limbs of formalin fixed, elderly, dissecting room cadavers and the samples prepared for paraffin and/or methylmethacrylate histology. Entheses from four young volunteers with no history of significant musculoskeletal injury were examined by magnetic resonance imaging using T(1) weighted sequences. RESULTS: Adipose tissue was present at several different sites at numerous entheses. Many tendons/ligaments lay on a bed of well vascularised, highly innervated, "insertional angle fat". Endotenon fat was striking between fascicles, where entheses flared out at their attachments. It was also characteristic of the epitenon, where it occurred in conjunction with lamellated and Pacinian corpuscles. Fat filled, meniscoid folds often protruded into joint cavities, immediately adjacent to attachment sites. CONCLUSION: Adipose tissue is a common feature of normal entheses and should not be regarded as a sign of degeneration. It contributes to the increase in surface area of attachment sites, promotes movement between tendon/ligament and bone, and forms part of an enthesis organ that dissipates stress. The presence of numerous nerve endings in fat at attachment sites suggests that it has a mechanosensory role and this could account for the rich innervation of many entheses. Because damage to fat is known to lead to considerable joint pain, our findings may be important for understanding the site of pain in enthesopathies. (+info)
Is there a need for anterior release for 70-90 degrees masculine thoracic curves in adolescent scoliosis?
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Large and stiff thoracic scoliotic curves in the adolescent represent a classic indication of anterior release followed by posterior instrumentation. However, third-generation segmental spinal instrumentations have shown increased correction of thoracic curves. Indication for an anterior release may therefore not be required even in large and stiff thoracic curves. The objective of the study was, therefore, to analyze retrospectively the results of third-generation segmental posterior instrumentation in large and stiff thoracic curves and to compare our results with the current literature of anterior release followed by posterior instrumentation. An independent observer, who had not participated in any of the case, reviewed our electronic database of adolescent scoliosis surgery (Scolisoft) with the following query: thoracic curves, Cobb angle between 70 degrees and 90 degrees and posterior surgery only. He was able to identify 19 patients whose thoracic curves were measured between 70 degrees and 90 degrees . Out of these, four had convex-side bending Cobb angle values of less than 45 degrees and were not included in the study, as they were judged too flexible. Fifteen patients (aged 11-18 years, mean 13.6 years) with thoracic scoliosis were left for the study (average Cobb angles 78.5 degrees with a flexibility index of 32.5% (range, 19-42%). The mean follow-up period was 32 months (range 18-64 months). Classic parameters of deformity correction were analysed. The average operative time was 314 min and the mean total blood loss was 1,875 ml. Average level of instrumented vertebrae was 12 (Range, 10-14). Postoperatively, the thoracic Cobb angle was measured at 34.8 degrees (range, 25-45 degrees ), which represents a correction rate of 54% (range, 40.0-67.1%) and remained unchanged at the last follow-up (35 degrees ). Patients with thoracic hypokyphosis improved from an average 11 degrees to 18 degrees . There were three complications (one excessive bleeding, one early infection and one late infection). One case showed an add-on phenomenon at the last follow-up. Coronal balance was improved from 1.8 cm (Range 0-4 cm) down to 0.75 cm (range 0-2.5 cm). Shoulder balance was improved from 1.3 cm (range 0-4 cm) down to 0.75 (0-2.5 cm). All patients reported satisfactory results except the patient with an adding-on phenomena. In the literature, most of the results of anterior thoracoscopic release and posterior surgery give a percentage of Cobb angle correction similar or inferior to our series for an average initial Cobb angle of less magnitude. Therefore, with adequate posterior release, and the use of third-generation segmental instrumentation there is no need for anterior release even for curves in the 70-90 degrees range. (+info)