The diagnosis and management of an expanding post-traumatic soft tissue cyst of the hip and groin.

A post-traumatic cyst is a rare complication of significant soft tissue trauma. It occurs at the junction between the subcutaneous fat and underlying fascia, when a large, subcutaneous haematoma fails to resolve, developing into a chronic, fluid-filled cyst, lined with fibrous tissue. This results in a swelling that persists for years, gradually increasing in size, often without causing significant discomfort to the patient. Clinically and radiologically these swellings may be mistaken for neoplastic lesions. They can be difficult to treat, are refractory to conservative management and have a high rate of recurrence following surgical excision. Careful monitoring and early treatment of persistent postoperative seroma is advocated.

A drill-free bone screw for intermaxillary fixation in military casualties.

Drill-free bone screws are a simple and quick method of establishing intermaxillary fixation requiring a minimum amount of specialist training or equipment. These screws offer significant advantages over other methods of intermaxillary fixation and are well suited for use in military casualties.

Expression of phenylethanolamine n-methyltransferase in the embryonic rat heart.

Phenylethanolamine N-methyltransferase (PNMT), the final enzyme in the pathway for epinephrine biosynthesis, serves as a marker for tissues and cells producing epinephrine. The present study examines the developmental expression of PNMT in the rat embryo. A transient burst in PNMT mRNA expression begins on embryonic day 9.5 (E9.5), peaks between E10.0 and E11.0, and declines to barely detectable levels by E13.0. Regional localization of PNMT mRNA and enzyme activity demonstrates that PNMT is concentrated in the heart. PNMT has not previously been reported to be expressed at these early stages of development, and its presence in the developing heart suggests that this embryonic tissue may produce epinephrine. Because this catecholamine is known to increase cardiac output and promote the growth of cardiomyocytes, local production of epinephrine by the heart could play an important role in the development of cardiac structure and function.

Axial rotation in rat embryos: morphological analysis and microsurgical study on the role of the allantois.

In mouse and rat embryos, the embryonic disc develops within a cup-shaped "egg cylinder" and consists of an inner layer of ectoderm and an outer layer of endoderm. Because of this configuration, the embryo first develops in a dorsally flexed position and then undergoes "axial rotation" to a ventrally flexed position. In the present study, we first analyzed the morphological process of axial rotation in rat embryos using novel reference axes set in the egg cylinder that remained invariant during the process. Our new perspective allowed us to demonstrate that the process consists of three movements which start at different stages of development: twisting of the upper body at stage 12/s7-8, twisting of the middle body at stage 13/s11-12, and twisting of the lower body (so called "tail") at stage 14/s15-16. Axial rotation is an interesting developmental event not only because it is such a dynamic process but also because it is one of the earliest morphological signs of body asymmetry. This asymmetry is strongly biased in that the tail almost always finishes up on the right side of the embryo for reasons that are still unknown. In the second part of the study, we performed microsurgical experiments to extend our previous finding that removal of the allantois results in random determination of tail sidedness. We demonstrated that an allantois transplanted from another embryo can prevent this abnormal sidedness in an embryos whose allantois had been removed and that transecting the allantois did not lead to abnormal tail sidedness. A possible explanation is that the allantois produces a chemical factor that controls tail sidedness.

Expression of mRNA for alpha1-adrenoceptor subtypes at the beginning of neurulation in rat embryos.

We recently reported that alpha1-adrenoceptor agonists, administered at the beginning of neurulation (Stage 11a) in rat embryos grown in culture, interfere with normal development of the left/right body axis leading to situs inversus. Despite these pharmacological findings, expression of alpha1-adrenoceptor genes at such an early stage of development has not been demonstrated. In the present study, we examined the expression of mRNAs for cloned alpha1-adrenoceptor subtypes in rat embryos at Stage 11a. Timed-pregnant Sprague-Dawley rats were killed in the morning of gestational day 9 (vaginal plug day = day 0), and the implantation sites were removed. The implantation sites were separated into embryo, ectoplacental cone and decidua, only those at Stage 11a were selected, and these were immediately frozen on dry ice, and subsequently their total RNA was isolated. RNase protection assays were then performed for cloned alpha1a-, alpha 1b- and alpha1d-adrenocepter subtypes using 20-30 mug of total RNA for each hybridization. In all tissues, strong and weak signals were detected for alpha1b- and alpha1a-adrenoceptor subtype mRNAs, respectively. In contrast, a signal for alpha1d mRNA was not detected in any tissues. These results, together with previous pharmacological findings, suggest the existence of alpha1a- and alpha1b-adrenoceptor subtypes in rat embryos at Stage 11a.

Staurosporine does not prevent adrenergic-induced situs inversus, but causes a unique syndrome of defects in rat embryos grown in culture.

Staurosporine, an alkaloid isolated from Streptomyces species, is commonly used as a protein kinase C (PKC) inhibitor in animal investigations. In the present study, we used this compound to determine whether alpha 1-adrenergic stimulation-induced situs inversus in rats is mediated by PKC. Embryos were explanted at 8 A.M. on day 9 of gestation. Those with a neural groove but with no visible neural folds (Stage 11a) were selected and were cultured in medium containing various concentrations of staurosporine with or without 50 microM of phenylephrine, an alpha 1-adrenergic agonist. At 10 A.M. on day 11 of gestation, embryos were examined for situs inversus and other abnormalities. Staurosporine, tested at 0.0001, 0.001, 0.01, 0.1, 0.375, and 0.5 microM (lethal concentration), did not block phenylephrine-induced situs inversus at any concentration. However, staurosporine alone produced situs inversus at concentrations above 0.1 microM. At 0.5 and 1.0 microM, staurosporine also caused cyst-like lesions projecting dorsally from the mesencephalon that we named "mesencephalic vesicles" and the formation of secondary somites. To confirm and further examine these unique effects of staurosporine both grossly and histologically, we conducted additional experiments using staurosporine from another source. Embryos were explanted between 6 A.M. and 9 P.M. on day 9 of gestation and were placed in one of the following groups according to their stage of development: 10b, 11a, 11b, 11c, 12/s1-2, 12/s3-4, and 12/s5-6. Embryos were then cultured with various concentrations of staurosporine. Those cultured from Stage 11a exhibited similar lesions to those seen in the initial experiment but at somewhat higher concentrations of staurosporine. Embryos cultured from Stage 10b showed a similar pattern of lesions as seen at Stage 11a, except that higher concentrations of staurosporine were required to cause mesencephalic vesicles and secondary somites formation. Embryos cultured from Stage 11b showed similar effects to those cultured from younger stages except that maximum incidences of situs inversus were much lower. Those cultured from Stage 11c showed similar dose-response to those cultured from Stage 11b except that the incidence of secondary somites formation was much higher. In addition, in approximately 40% (n = 25) of embryos treated with greater than 1.0 microM of staurosporine, the growing end of the allantois did not reach the chorion and remained unattached in the exocoelomic cavity.(ABSTRACT TRUNCATED AT 400 WORDS)

Methionine prevents nitrous oxide-induced teratogenicity in rat embryos grown in culture.

BACKGROUND: Nitrous oxide (N2O)-induced teratogenicity in rats is commonly believed to be due to decreased tetrahydrofolate, which results in decreased DNA synthesis. The role of decreased methionine has been largely ignored as have the sympathomimetic effects of N2O. METHODS: A rat whole-embryo culture system was used to determine whether N2O-induced teratogenicity can be prevented with supplemental methionine or folinic acid and whether N2O-induced situs inversus is mediated by alpha 1-adrenergic stimulation. Embryos were explanted on day 9 of gestation, and those at stage 10b (late primitive streak stage) were cultured with or without N2O and the various chemicals, methionine (25 micrograms.ml-1), folinic acid (5 micrograms.ml-1), phenylephrine (range 0.5-50 microM) and prazosin (10 microM). Embryos in the N2O groups were exposed to a concentration of 75% for the first 24 h of culture. After 50 h of culture, embryos were examined for abnormalities including situs inversus. RESULTS: Treatment with N2O alone resulted in increased incidences of malformations and growth retardation. Methionine, but not folinic acid or prazosin, almost completely prevented N2O-induced malformations and growth retardation. N2O itself did not cause situs inversus but increased the incidence of phenylephrine-induced situs inversus. This additive effect was blocked by prazosin. CONCLUSIONS: Our results indicate that decreased methionine rather than decreased tetrahydrofolate plays the major role in N2O-induced teratogenicity in rats. They also indicate that N2O stimulates the alpha 1-adrenergic pathway in the embryo and thereby increases the incidence of phenylephrine-induced situs inversus.

Receptor subtype and intracellular signal transduction pathway associated with situs inversus induced by alpha 1 adrenergic stimulation in rat embryos.

In previous studies, we have demonstrated that stimulation of alpha 1 but not alpha 2 or beta adrenergic receptors in rat embryos grown in culture interferes with normal development of the left/right body axis leading to situs inversus. In the present study, we aimed to determine the alpha 1 adrenergic receptor subtype and signal transduction pathway involved in this phenomenon. Rat embryos at Stage 11a by a modified Theiler's staging system were cultured for 50 hr in medium containing various compounds which are known to activate or inhibit different sites of the signal transduction pathways associated with alpha 1 adrenergic receptors. They were then examined to determine the sidedness of asymmetric body structures. WB4101, a selective antagonist of alpha 1A adrenergic receptor subtype, but not chlorethylclonidine, a selective antagonist of alpha 1B adrenergic receptor subtype, inhibited phenylephrine (an alpha 1 adrenergic agonist)-induced situs inversus. Neither the protein kinase C (PKC) activators phorbol 12-myristate 13-acetate and SC-9 nor the PKC inhibitor calphostin C caused situs inversus. Furthermore, calphostin C did not block phenylephrine-induced situs inversus. A23187, a Ca2+ ionophore, induced situs inversus; nifedipine, a L-type Ca2+ channel blocker, partially blocked phenylephrine-induced situs inversus. The calmodulin antagonists trifluoperazine, W-7, and W-13 blocked phenylephrine-induced situs inversus, although they did not cause situs inversus by themselves. KN-62, a Ca2+/calmodulin-dependent protein kinase II (CaM kinase II) inhibitor, dose-dependently blocked phenylephrine-induced situs inversus. However, higher concentrations of this compound produced no block in the presence of phenylephrine and in its absence produced a 50% incidence of situs inversus. These results indicate that alpha 1 adrenergic stimulation-induced situs inversus is mediated by the alpha 1A adrenergic receptor subtype and that activation of CaM kinase II but not PKC may be involved.

Microsurgical study on the mechanisms determining sidedness of axial rotation in rat embryos.

Sidedness of left/right asymmetric body structures is strongly biased in most animals by mechanisms that are not well understood. In rat embryos, axial rotation starts at the 9-10 somite stage and is almost completed at the 17-18 somite stage. As a result, the ventrally flexed tail (caudal part of the body) and chorioallantoic placenta on the yolk sac take up their position normally on the right side of the embryo. Because the tail and chorion become connected via the allantois around the time when axial rotation takes place, we hypothesized that the allantois and possibly its connection to the chorion is important in determining sidedness of the tail. In the present study, we tested this hypothesis by surgically removing either the allantois or chorion before axial rotation started. Embryos were explanted at 8 AM on Day 9 of gestation (presomite stage), and either the allantois or chorion was removed using microforceps. Embryos were then cultured in rotating bottles, and sidedness of the tail, chorioallantoic placenta, and bulboventricular loop (heart) was determined after 50 hours (approximately 25-26 somite stage). Removal of the allantois (n = 55) resulted in absence of the umbilical cord and a 49.1% incidence of inverted tail; a chorioallantoic placenta-like structure developed on the yolk sac in the normal position.(ABSTRACT TRUNCATED AT 250 WORDS)

Comparison of staging systems for the gastrulation and early neurulation period in rodents: a proposed new system.

Because there is no standard developmental staging system for the early postimplantation period of rodent embryos, investigators must now choose between a variety of systems that differ significantly. We have reviewed many of these staging systems and have summarized the ambiguities within them and the inconsistencies among them. In order to compare systems, we first obtained a consensus of the order of developmental events from the literature, and then attempted to fit existing systems into this order taking into account inconsistencies in terminology and blurred borderlines between stages. We were able to do this for most systems but not all because some were too divergent. We found that inconsistencies in definition of some terms, such as "primitive streak stage" and those used to describe the early neurulation process (neural plate, neural groove, neural folds, and head fold) cause much confusion. In order to develop an unambiguous system which can be used by all investigators, we propose to modify Theiler's system, which is one of the most commonly used systems but is not defined precisely during the early postimplantation period. We suggest making subdivisions of the original stages as follows: 1) stage 8 into 8a and 8b, by the degree of extension of the proamniotic cavity into the extraembryonic region; 2) stage 10 into 10a and 10b, by the completion of amnion formation; 3) stage 11 into 11a, 11b, and 11c, by the appearance of neural folds and foregut pocket. After Stage 12, the number of somite pairs can be used to precisely stage embryos.(ABSTRACT TRUNCATED AT 250 WORDS)

Developmental toxicity of nondepolarizing muscle relaxants in cultured rat embryos.

Evidence of developmental toxicity of clinically used nondepolarizing muscle relaxants was sought in rat embryos grown in culture. Embryos were explanted at 8 AM on day 9 of gestation (presomite stage, plug day = day 0), and were cultured in rotating bottles with medium containing various concentrations of d-tubocurarine, pancuronium, atracurium, and vecuronium. At 10 AM on day 11 of gestation (forelimb bud stage), culture was terminated and embryos were examined for general morphology. Treatment with tested agents resulted in dose-dependent developmental toxicity; namely, growth retardation seen as decreased crown-rump length, decreased number of somite pairs, and morphologic abnormalities. However, the concentrations that caused toxicity were at least 30-fold greater than serum concentrations clinically achieved in the mother. We conclude that these muscle relaxants have a low potential for causing developmental toxicity during organogenesis.

Variation in development of rat embryos at the presomite period.

Rat embryos at a single gestational time in the presomite period were studied for their variation in development and their fate after culture. They were explanted at 8 A.M. on day 9 of gestation from timed-pregnant Sprague-Dawley rats which were obtained by mating between 8 and 10 A.M. (plug day = day 0). In the first experiment, a total of 203 embryos from 20 litters were examined for their variation in development. Several dimensions of embryo/egg cylinder were measured and development of various embryonic/extraembryonic structures were assessed using a scoring system that we developed for the present study. Embryos were then divided into different stages of development based on their scores using the staging system that we developed previously. A large variation in developmental stage was demonstrated; the youngest embryo was at the early primitive streak stage with no signs of amniotic folds and the oldest one was at the late neural plate stage with a foregut pocket but without visible somites. No strong correlation was demonstrated between developmental stage and size of embryo/egg cylinder, nor between developmental stage and development of the proamniotic tube, ectoplacental cavity, or allantois. In the second experiment, embryos were explanted at the same time and those at different stages were cultured separately in rotating bottles and their outcomes were compared after 49 hours. The difference in mean somites number of embryos cultured from the mid primitive streak and late neural plate stages was 6.1. This difference corresponds to approximately 10 hours based on the known linear increase of somites number on day 11 of approximately 0.6 somites per hour. These results indicate a large variation in development of presomite period embryos supposedly of the same gestational age and suggest the importance of careful staging at the time of explantation if precision is needed for whole embryo culture experiments.

Activation of alpha-1 adrenergic receptors modulates the control of left/right sidedness in rat embryos.

Presomite stage rat embryos were cultured for 45-49 hr with medium containing various adrenergic agonists and antagonists. L-Norepinephrine but not D-norepinephrine (several orders of magnitude less potent than the L-isomer at alpha-1 adrenergic receptors) resulted in a dose-dependent increase of situs inversus similar to that found for phenylephrine, an alpha-1 adrenergic agonist. Prazosin, an alpha-1 adrenergic antagonist, inhibited phenylephrine-induced situs inversus in a dose-dependent manner. Neither dexmedetomidine, an alpha-2 adrenergic agonist, nor isoproterenol, a beta adrenergic agonist, caused situs inversus. These results provide pharmacological evidence that stimulation of alpha-1 but not of alpha-2 and beta adrenergic receptors modulates the control of left/right sidedness in rat embryos.

Critical period of rat development when sidedness of asymmetric body structures is determined.

We recently reported that rat embryos cultured from the presomite stage in a medium containing the alpha-1 adrenergic agonist, phenylephrine, have a high incidence of situs inversus. In the present study, we have determined more precisely the critical period of development when situs inversus is induced. Rat embryos were harvested at 8 AM on Day 9 of gestation (plug day = Day 0), and divided into different stages of development, namely, early, mid, and late primitive streak stages and early, mid, and late neural plate stages. They then were cultured in rotating bottles to which phenylephrine, 0.5 mM, was added for various durations. After 49 hr of culture, embryos were examined for general morphology including sidedness of the bulboventricular loop, tail, and chorioallantoic placenta. Phenylephrine increased the incidence of situs inversus above control when administered throughout culture from either the early neural plate stage or before, and when administered for 4 hr or more from the early neural plate stage. This increase was significant even at the mid and late primitive streak stages when the control incidence was high. Our results suggest that sidedness of asymmetric body structures is determined during the early neural plate stage. This period is well before the 6-8-somite stage when morphological signs of body asymmetry first appear.

Effects of nitrous oxide on day 9 rat embryos grown in culture.

A rat whole embryo culture system was used to study the adverse reproductive effects of nitrous oxide. Embryos were removed on day 9 of gestation and exposed in culture to several concentrations of nitrous oxide for 24 h. After an additional 25 h of culture, embryos were examined for morphological abnormalities and were assayed later for protein content. Nitrous oxide resulted in growth retardation and an increased incidence of morphological abnormalities and altered body laterality. The conditions required to produce abnormalities were similar to those required in vivo. We conclude that nitrous oxide has direct toxic effects on the developing embryo and that day 9 embryo culture is a useful technique for studying mechanisms of nitrous oxide-induced teratogenicity.

Preventive effects of phenoxybenzamine on nitrous oxide-induced reproductive toxicity in Sprague-Dawley rats.

In previous studies, we have shown that the reproductive toxicity of N2O in rats is prevented by the co-administration of either halothane or isoflurane, whereas treatment with folinic acid, which should reverse the effects of N2O on DNA production, does not prevent toxicity. These results cast doubt on the commonly held theory that inactivation of methionine synthase is the sole cause of N2O-induced reproductive toxicity, and suggest the need for other hypotheses. One such possibility is that N2O causes adverse reproductive toxicity secondary to its sympathomimetic effects. As a first step to test this theory, we studied the effects of phenoxybenzamine (PX), an alpha-1 adrenergic antagonist, on N2O-induced reproductive toxicity using a well-established in vivo rat model. On day 8 of gestation (plug day = day 0), 130 timed-pregnant Sprague-Dawley rats were injected s.c. with either 0.5 ml of either 0.9% saline (control and N2O alone groups) or PX (0.5, 5, or 50 micrograms/kg) in 0.9% saline, the latter the maximum tolerated PX dose. They were then exposed to either air (control) or 60% N2O for 24 hours (all other groups). On day 20 of gestation, cesarean sections were performed and the fetuses were removed and examined for either visceral of skeletal abnormalities. Compared with control, treatment with N2O alone resulted in increased incidences of fetal resorptions, major and minor visceral abnormalities, and minor skeletal abnormalities.(ABSTRACT TRUNCATED AT 250 WORDS)