The histopathology of the humeral head in glenohumeral osteoarthritis.

Objective: The histopathologic wear patterns in glenohumeral osteoarthritis (GOA) have not been described. The aims of the study were to a) describe the histopathology of humeral head wear patterns in patients with end-stage GOA and b) identify clinical and radiographic parameters that correlate with observed histopathological wear patterns. Methods: Eighteen humeral heads from patients undergoing anatomic total shoulder arthroplasty for end-stage osteoarthritis were divided radially into eight wedge-shaped zones. Each zone was subdivided into central and peripheral regions. Histologic analysis included measurements of cartilage and subchondral bone plate thickness, subchondral bone area, and cartilage structure was scored using the Osteoarthritis Research Society (OARSI) and modified Mankin systems. Clinical variables including patient history, physical exam, functional evaluation, and radiographic assessments were evaluated for correlations with humeral head characteristics. Results: Overall, humeral heads demonstrated a pattern of central and inferior cartilage damage, loss, and subchondral bone changes. However, within the group, composite maps of individual patient wear patterns demonstrated a sub-group of patients with a more focal inferior cartilage lesion. Overall, these more focal inferior lesions were associated with greater pre-operative range of motion (in both upper extremities), higher pre-operative SANE and ASES scores, female sex, non-dominant extremity, concentric wear patterns, and smaller inferior osteophytes. Conclusion: Humeral head cartilage wear patterns in GOA include central and inferior cartilage damage and loss. A histopathological distinction was identified between patients with more focal versus diffuse wear, which may manifest clinically with preservation of function and range of motion, and with less profound radiographical changes.

Vaginoplasty from peritoneal tube of Douglas' pouch for congenital vaginal agenesis.

Vaginal reconstruction using skin and sigmoid loop has resulted in complications like dryness, stenosis and hair growth in the graft in the former and mucus discharge in the latter. A case of Douglas' pouch peritoneal tube vaginoplasty in a girl of 17 years with absent vagina is reported with satisfactory functional results. The procedure is much less invasive than the currently described methods.

Deflating proximal enterostomy for jejunoileal atresia.

A modification is described to avoid postoperative gaseous distension and facilitate early oral feeding after resection and anastomosis for jejunoileal atresia.

The phylogenetic odyssey of the erythrocyte. IV. The amphibians.

Amphibians manifest permanently nucleated, oval, flattened, biconvex erythrocytes. These cells demonstrate a cytoskeleton which is responsible for their morphogenetic conversion from a sphere to an ellipse and imparts to their cellular mass reversibility of traumatic deformation. The class Amphibia has the largest of all erythrocytes attaining volumes greater than 10,000 femtoliters in the Amphiuma. The large dimensions reflect evolutionary processes, genomic size, ploidy and the relative size of other somatic cells. Conversely, the erythrocyte count and hemoglobin concentration of these species are low. Occasional denucleated red cells can be seen in the peripheral blood but may attain levels of 90-95% of the total circulating population in certain members of the tribe Bolitoglossini (e.g. Batrachoseps attenuatus). These erythroplastids retain the marginal band thus remaining different from mammalian erythrocytes. Embryologically, erythropoiesis initiates in the yolk sac and then progresses to the kidney, liver, and possibly spleen. The yolk sac cohort is transitory and is successively replaced by the larval and definitive populations of erythrocytes. Red cell production (along with thrombocytopoiesis) in adult urodeles is conducted intravascularly in the spleen. In anurans this organ is usually the major site although the liver also serves as a secondary locus for this activity. Medullary (bone marrow) erythropoiesis makes its phylogenetic debut in anurans and typically occurs during heightened hemopoiesis following metamorphosis or hibernation. Maturation of the erythrocyte in the circulation is commonplace (especially in urodeles) while proliferation at this site is inducible by splenectomy and/or hemolysins. Erythrocyte-related values demonstrate variable differences associated with age, weight, season, gender, and environment.

The phylogenetic odyssey of the erythrocyte. III. Fish, the lower vertebrate experience.

The piscine erythrocyte can be considered the prototype of the red cells that are distributed among inframmalian vertebrates. It is a permanently nucleated, hemoglobin-ladened, oval, flattened, biconvex disc. Ultrastructurally it demonstrates a cytoskeleton comprised of a marginal band and a membrane skeleton which are responsible for the erythrocyte's conversion to an ellipsoid during morphogenesis and endow it with resilience to physical trauma. Erythropoiesis initiates in the yolk sac, followed in many fishes, by the intermediate cell mass. These sites are the sources of the transitory, primitive generation red cells which apparently make their first phylogenetic appearance in fishes and which are subsequently represented in all classes of vertebrates including mammals. Production of definitive generation erythrocytes is centered in evolutionary "pre-splenic" tissue of the gastrointestinal tract or in the spleen in cyclostomes, dipnoi, and chondrichthyes while in teleosts it is typically located in the kidneys with or without splenic participation. The blood is a major site of erythrocyte maturation in the lower fishes and exhibits significant numbers of immature erythroid cells plus occasional mitotic figures. Some teleosts also circulate developing erythroid cells. Certain fishes have occasional circulating erythroplastids, conceptually a portent of phylogenetic changes in higher vertebrates. Remarkably, some bristlemouths have denucleated erythrocytes exclusively in the circulation. The largest piscine erythrocytes are found in the dipnoi, myxines, and chondrichthyes. Primitive fish with the exception of the endothermic sharks tend to have lower hemoglobin concentrations than the modern teleosteans. The very highest hemoglobin concentrations are attained by the endothermic scombrids. Erythrocyte-based data have a broad extent and are variably affected by age, sex, season and environment. This report includes a substantial selection of illustrations (fish species and rbc micrographs).

Localization of the gene for plasma retinol binding protein to the distal half of mouse chromosome 19.

A DNA polymorphism for the mouse retinol binding protein has been identified using the enzyme BamHI and a rat partial cDNA probe. Analysis of the polymorphism in DNA from 64 inbred mouse strains demonstrated the presence of a single gene with two alleles, Rbp-4b and Rbp-4d. Comparison of the segregation patterns of these alleles in three sets of recombinant inbred strains with allele segregation patterns of previously characterized loci shows that the Rbp-4 locus is closely linked to the locus for phenobarbital-inducible cytochrome P450-2c (Cyp-2c) that has been shown by in situ hybridization to lie on chromosome 19, bands D1-D2. The Rbp-4 locus is just proximal to Cyp-2c at the distal end of chromosome 19.