Radiographic analysis to determine the treatment outcome in developmental dysplasia of the hip.

The purpose of this retrospective study was to determine whether pretreatment radiographic findings of patients less than 6 months old with developmental dysplasia of the hip can predict treatment outcome. Medical records and radiographs were reviewed in a cohort of 35 patients (44 hips) less than 6 months old with a diagnosis of hip dislocation at one institution. Using pretreatment anteroposterior radiographs, we measured the superior gap (distance between the proximal metaphysis to Hilgenreiner's line) and the medial gap (distance between the femoral calcar and the lateral pelvic wall at that level) and analyzed these data along with the type of splint used (Pavlik harness verses other abduction orthosis). Medical records and radiographs from an aged-matched cohort of 20 patients (23 hips) treated at a second institution were analyzed by using the same clinical and radiographic criteria of hip dislocation. Of the 44 dislocated hips, 29 failed with a trial of splintage (66%). Of the 23 dislocated hips from the second institution, 16 failed a trial of splintage (70%). Statistical analysis evaluating the age of the patient, medial and superior gaps, and harness type revealed that an abnormal superior and medial gap consistently predicted success or failure of splintage. We concluded that infants with pretreatment radiographs revealing a superior gap equal to or less than 3 mm, or a medial gap equal to or greater than 10 mm should not be treated with an initial trial of splintage because failure is likely.

The role of CCR7 in TH1 and TH2 cell localization and delivery of B cell help in vivo.

Subsets of murine CD4+ T cells localize to different areas of the spleen after adoptive transfer. Naïve and T helper 1 (TH1) cells, which express the chemokine receptor CCR7, are home to the periarteriolar lymphoid sheath, whereas activated TH2 cells, which lack CCR7, form rings at the periphery of the T cell zones near B cell follicles. Retroviral transduction of TH2 cells with CCR7 forces them to localize in a TH1-like pattern and inhibits their participation in B cell help in vivo but not in vitro. Thus, differential expression of chemokine receptors results in unique cellular migration patterns that are important for effective immune responses.

Cooperation between Th1 and Th2 cells in a murine model of eosinophilic airway inflammation.

We have studied the actions of helper T lymphocyte-1 and -2 (Th1 and Th2) cells in an acute model of eosinophilic airway inflammation by infusing chicken ovalbumin-specific (OVA-specific) Th1 cells, Th2 cells, or both into unsensitized mice and challenging the mice with an OVA aerosol. OVA challenge after infusion of Th1 cells alone resulted in airway inflammation with lymphocytes and monocytes. Challenge after the infusion of Th2 cells alone resulted in minimal inflammation. In contrast, when Th1 and Th2 cells were transferred together, they cooperated to promote a robust eosinophil-predominant inflammatory response. Th1 cells alone were readily recruited to the airways after challenge, but in the absence of Th1 cells, Th2 cells did not accumulate in the airways. When transferred together, both Th1 and Th2 cells, as well as endogenous eosinophils, were effectively recruited. This recruitment was correlated with increased VCAM-1 expression in the medium- and large-sized vessels of the lung and could be inhibited by treating the mice with neutralizing antibodies to TNF-alpha or VCAM-1. These data indicate that Th2 cells require signals in addition to antigen for their effective recruitment to the airways. Th1 cells can provide these signals.

Modulation of airway inflammation by passive transfer of allergen-specific Th1 and Th2 cells in a mouse model of asthma.

Although evidence is strong that Th cells play a major role in mediating the airway inflammation observed in asthma, the relative contributions of the Th cell subsets, Th1 and Th2, are unclear. It has been suggested that asthma is driven by Th2 predominant responses in the lung, but other data suggest a role for Th1 cells as well. Here we show by intracellular cytokine staining and flow cytometric analysis that in the murine model of OVA-induced airway inflammation, both Th1 and Th2 cells are recruited to the airways. Th1 cells predominate early in the response and Th2 cells predominate late. We further show that increasing the number of Th1 cells by passive transfer of OVA-specific Th1 cells results in increased inflammation. This effect is observed regardless of whether the T cells are transferred before sensitization or after airway inflammation is already in progress. Transfer of Th1 cells also results in increased recruitment of host T cells of both Th1 and Th2 phenotypes. Passive transfer of Th2 cells results in little change in the inflammatory response. These results demonstrate that Ag-specific Th1 cells are not protective in this model of asthma, but rather may potentiate the inflammatory response.

Fat-suppressed MRI of musculoskeletal infection: fast T2-weighted techniques versus gadolinium-enhanced T1-weighted images.

PURPOSE: To investigate gadolinium's role in imaging musculoskeletal infection by comparing the conspicuity and extent of inflammatory changes demonstrated on gadolinium-enhanced fat-suppressed T1-weighted images versus fat-suppressed fast T2-weighted sequences. DESIGN: Eighteen patients with infection were imaged in a 1.5-T unit, using frequency-selective and/or inversion recovery fat-suppressed fast T2-weighted images (T2WI) and gadolinium-enhanced frequency-selective fat-suppressed T1-weighted images (T1WI). Thirty-four imaging planes with both a fat-suppressed gadolinium-enhanced T1-weighted sequence and a fat-suppressed T2-weighted sequence were obtained. Comparison of the extent and conspicuity of signal intensity changes was made for both bone and soft tissue in each plane. RESULTS: In bone, inflammatory change was equal in extent and conspicuity on fat-suppressed T2WI and fat-suppressed T1WI with gadolinium in 19 planes, more extensive or conspicuous on T2WI in three planes, and less so on T2WI in two planes. Marrow was normal on all three sequences in 10 cases. In soft tissue, inflammatory change was seen equally well in 20 instances, more extensively or conspicuously on the T2WI in 11 instances, and less so on T2WI in 2 instances. One case had no soft tissue involvement on any of the sequences. Five abscesses and three joint effusions were present, all more conspicuously delineated from surrounding inflammatory change on the fat-saturated T1WI with gadolinium. The average imaging time for the fat-saturated T1WI with gadolinium was 6.75 min, while that of the T2-weighted sequences was 5.75 min. CONCLUSION: Routine use of gadolinium is not warranted. Instead, gadolinium should be reserved for clinically suspected infection in or around a joint, and in cases refractory to medical or surgical treatment due to possible abscess formation.

PCR-based gene targeting of the inducible nitric oxide synthase (NOS2) locus in murine ES cells, a new and more cost-effective approach.

Gene targeting by double homologous recombination in murine embryonic stem (ES) cells is a powerful tool used to study the cellular consequences of specific genetic mutations. A typical targeting construct consists of a neomycin phosphotransferase (neo) gene flanked by genomic DNA fragments that are homologous to sequences in the target chromosomal locus. Homologous DNA fragments are typically cloned from a murine genomic DNA library. Here we describe an alternative approach whereby the inducible nitric oxide synthase (NOS2) gene locus is partially mapped and homologous DNA sequences obtained using a long-range PCR method. A 7 kb NOS2 amplicon is used to construct a targeting vector where the neo gene is flanked by PCR-derived homologous DNA sequences. The vector also includes a thymidine kinase (tk) negative-selectable marker gene. Following transfection into ES cells, the PCR-based targeting vector undergoes efficient homologous recombination into the NOS2 locus. Thus, PCR-based gene targeting can be a valuable alternative to the conventional cloning approach. It expedites the acquisition of homologous genomic DNA sequences and simplifies the construction of targeting plasmids by making use of defined cloning sites. This approach should result in substantial time and cost savings for appropriate homologous recombination projects.

Expression of Janus kinase 3 in human endothelial and other non-lymphoid and non-myeloid cells.

Members of the Janus kinase (Jak) family of protein tyrosine kinases have recently been implicated in the proximal signal transduction events of cytokine receptors. Jak3, a newly discovered member of this family, is believed to be normally limited in its expression to cells of the lymphoid and myeloid lineages. Herein we show that Jak3 is expressed in primary human vascular cells, as well as other non-lymphoid and non-myeloid cell types. Reverse transcriptase-polymerase chain reaction and Northern blot analysis revealed that Jak3 mRNA was expressed at low levels in human umbilical vein endothelial cells (HUVEC), human aortic smooth muscle cells (HASMC), A549 (human lung carcinoma), and DLD-1 (human colon adenocarcinoma) cells. Higher basal levels of Jak3 mRNA were detected in HMEC-1 (human microvascular cell line) and HepG2 (human hepatocellular carcinoma) cells. Jak3 mRNA expression was induced in HUVEC, HMEC-1, and HASMC by treatment with interleukin-1beta, tumor necrosis factor-alpha, interferon-gamma, and lipopolysaccharide. Jak3 protein was detectable at low levels in untreated HMEC-1, and these levels increased significantly with cytokine treatment. Furthermore, Jak3 protein was phosphorylated upon treatment of these cells with interleukin-4. This work shows that Jak3 is expressed or inducible in human vascular endothelial, vascular smooth muscle, and other non-lymphoid and non-myeloid cells, suggesting a broader role for Jak3 in the cytokine signal transduction of these cells.