Co-culture of mechanically injured cartilage with joint capsule tissue alters chondrocyte expression patterns and increases ADAMTS5 production.

We studied changes in chondrocyte gene expression, aggrecan degradation, and aggrecanase production and activity in normal and mechanically injured cartilage co-cultured with joint capsule tissue. Chondrocyte expression of 21 genes was measured at 1, 2, 4, 6, 12, and 24h after treatment; clustering analysis enabled identification of co-expression profiles. Aggrecan fragments retained in cartilage and released to medium and loss of cartilage sGAG were quantified. Increased expression of MMP-13 and ADAMTS4 clustered with effects of co-culture, while increased expression of ADAMTS5, MMP-3, TGF-beta, c-fos, c-jun clustered with cartilage injury. ADAMTS5 protein within cartilage (immunohistochemistry) increased following injury and with co-culture. Cartilage sGAG decreased over 16-days, most severely following injury plus co-culture. Cartilage aggrecan was cleaved at aggrecanase sites in the interglobular and C-terminal domains, resulting in loss of the G3 domain, especially after injury plus co-culture. Together, these results support the hypothesis that interactions between injured cartilage and other joint tissues are important in matrix catabolism after joint injury.

Early mobilization following angioplasty.

AIM: To assess the incidence of puncture site complications in in-patients undergoing early mobilization following angioplasty with a view to performing day case angioplasty. MATERIALS AND METHODS: One hundred and twenty-eight patients undergoing peripheral and renal angioplasty using a sheath size of up to 6 French were recruited prospectively. The mobilization protocol consisted of supine bed rest for 2 h, followed by gradual mobilization, so that the patient was ambulant 4 h after the procedure. Mobilization was delayed if clinically appropriate. Puncture sites were scored for discomfort, paraesthesia, visible bruising and palpable haematoma after groin compression and the following morning. RESULTS: One hundred and forty-four puncture sites were studied. There were 44 haematomas in total, of which 37 (26%) were less than 2.5 cm and seven (4.9%) were between 2.5 cm and 7.5 cm. Four patients (2.8%) had visible bruising greater than 7.5 cm. No patient assessed discomfort higher than moderate at any stage. Mobilization was delayed in 15 patients. In 11 this was due to puncture site oozing, haematoma in one, two were hypertensive and one required surgery for limb ischaemia. All complications occurred within 4 h of angioplasty. No patient required surgery or transfusion for haemorrhagic complications. CONCLUSION: Mobilization at 4 h was successful in 90% of cases but 10% require more prolonged bed rest. No delayed complications occurred. These results suggest that day case angioplasty is feasible in most cases.Butterfield, J. S. (2000). Clinical Radiology55, 874-877

Real-time detection technique for Doppler optical coherence tomography.

We propose and demonstrate a novel detection technique, based on a modified electronic phase-locked loop, for Doppler optical coherence tomography. The technique permits real-time simultaneous reflectivity and continuous, bidirectional velocity mapping in turbid media over a wide velocity range with minimal sensitivity penalty compared with conventional optical coherence tomography, which is a major advance over current postprocessing and discrete parallel detection techniques.

The use of TIPS to control bleeding caput medusae.

Two patients with cirrhosis and portal hypertension had persistent bleeding from caput medusae and ascites. Transjugular intrahepatic portosystemic shunt (TIPS) resulted in regression of the caput medusae and ascites in both cases.

Isolated splenic metastases from colon carcinoma.

It is generally accepted that splenic metastases from colorectal carcinoma occur concurrently with widespread dissemination of the tumor. The case reviewed is notable for its long disease-free interval, isolated splenic metastasis and favorable-outcome postsplenectomy. It represents the fourth case report in the English literature of surgical resection for an isolated splenic metastasis from colorectal carcinoma.

The callosal-septal interface lesion in multiple sclerosis: effect of sequence and imaging plane.

We examined the effect of imaging plane and sequence on the demonstration of lesions at the callosal-septal interface (CSI) by magnetic resonance imaging in 20 patients with known multiple sclerosis. Variable-echo-(VE) T2- and proton density (PD) weighted images were performed in coronal axial and sagittal planes. Sagittal gradient echo (GE) T2- and PD-weighted images were also performed. Lesions at the CSI were seen in all patients and were all demonstrated on both sagittal and coronal VE images. Sagittal PD-weighted GE images were slightly less sensitive but showed good overall agreement with sagittal VE. Axial VE and sagittal T2-weighted GE images demonstrated CSI lesions poorly.

CT appearances of haematomas in the corpus callosum in patients with subarachnoid haemorrhage.

Corpus callosum haematoma is a rare feature in subarachnoid haemorrhage (SAH), which may result from aneurysms of the anterior communicating artery (ACoA) or pericallosal artery (PCA). In 348 patients with aneurysmal SAH, bleeding from ACoA aneurysms in 88 cases produced no abnormality on CT in 7. Blood in the cistern of the lamina terminalis was the most frequent abnormality (76/88); haematomas of the septum pellucidum, confined to patients with ACoA aneurysms, were seen in 26 (30%). Rupture of PCA aneurysms in 12 patients gave rise to blood in the pericallosal cistern, anterior interhemispheric fissure and cistern of the lamina terminalis in 11. There was no blood in the septum pellucidum or the ventricular system in any case, but haematomas in the corpus callosum occurred in 8 (67%). In all of these, blood extended into the anterodorsal aspect of the callosum and spread posteriorly along its dorsal border. An identical, supracallosal pattern was seen in 2 patients (2.5%) with ACoA aneurysms, in whom haemorrhage was more extensive, with a large frontal lobe haematoma extending up from the cistern of the lamina terminalis in 1 and a haematoma of the septum pellucidum, with intraventricular extension in the other. In 8 patients (9%) with ACoA aneurysms a corpus callosum haematoma appeared to result from passage of blood up through the cistern of the lamina terminalis into the septum pellucidum and thence into the ventral aspect of the anterior corpus callosum; blood was present within the cistern, the septum and the ventricles.

Bronchogenic cysts above and below the diaphragm: report of eight cases.

Bronchogenic cysts are developmental foregut anomalies usually located within the mediastinum. Although typically asymptomatic, infection or compression of adjacent structures may become prominent. Surgical excision is recommended to establish diagnosis, alleviate symptoms if present, and prevent future complications. We report our recent experience with bronchogenic cysts including 7 located within the mediastinum and a rare instance of a cyst below the diaphragm.