Recurrent Legg-Perthes-Calvé disease.

INTRODUCTION: Legg-Perthes-Calvé disease (LPC), or primitive hip osteochondritis, is a frequent pathology but in which recurrence is extremely rare. WE REPORT: The case of a girl diagnosed with bilateral LPC at the age of 4.5 years. Containment in a Scottish-Rite (Atlanta) brace was prescribed. X-ray follow-up found complete right-hip healing at 1.5 years' evolution (Catterall group 2). The patient was seen again at the age of 8 years, for limp and functional disorder associated with recurrence of right-hip LPC (Catterall group 3). Evolution was satisfactory: the girl was assessed at the time of bone maturity, with good clinical and radiological findings. DISCUSSION: Children contracting LPC are commonly thought to be thereby "vaccinated" against it. This is wrong, and a literature search found 10 cases similar to the present one, making 11 children in all (two girls, nine boys) presenting with recurrent LPC. Mean age at initial onset was 4 years (range, 2.5-6 yrs). Five of the 11 had initially been presented with bilateral LPC. Mean age at recurrence was 9.4 years (range, 6-12 yrs). The recurrences were more severe than the initial episodes, but final prognosis after recurrence would not seem to be worse than normal. CONCLUSION: This exceptional case of recurrent LPC was well documented up to bone maturity. It does not support the notion of Meyer's disease at the initial episode, as suggested by certain authors, but rather that of true recurrence of the primitive LPC.

[Axial lower limb alignment and knee geometry in patients with osteoarthritis of the knee]. / Analyse segmentaire de la déformation frontale dans les gonarthroses fémoro-tibiales latéralisées.

PURPOSE OF THE STUDY: We conducted a retrospective radiographic study to identify and quantify medial and lateral misalignments in candidates for total knee arthroplasty. MATERIAL AND METHODS: We studied a discontinuous series of 101 patients (164 knees) among candidates for total knee arthroplasty seen between 1990 and 2002. We selected a random sample for study. Exclusion criteria were any history of fracture, surgical treatment, rheumatoid disease, or congenital disorder. A first group of 136 genu varum knees was identified in 82 patients (mean age 72 years, mean weight 79 kg). A second group of 28 genu valgum knees was identified in 19 patients (mean age 67 years, mean weight 71 kg). The standard radiograms were digitalized for semi-automatic measurements using the Metros software. We recorded overall deformation, femoral valgus, tibial varus, HKA angle, HKS angle (mechanical/anatomic axis of the femur) and angle C (horizontal inclination of the ankle to the ground). All measures were compared between each other for each patient to search for relations. RESULTS: In the genu varum group (136 knees), mean overall deformation was 9 degrees , mainly due to tibial misalignment (5.5 degrees ) with a 1 degrees femoral valgus component. The HKS angle was 6.3 degrees , and lateral joint gap 4.3 degrees ; the C angle was 4 degrees . Overall varus followed tibial varus (p<0.01). Ankle inclination followed tibial varus (p<0.01). In the genu valgum group (28 knees), overall deformation was 4.2 degrees , mainly due to femoral misalignment (5.6 degrees) with 1 degrees tibial varus and a medial joint gap of 2 degrees . The HKS angle was 4.7 degrees and the mean C angle -4 degrees . Overall valgus was related to femoral valgus (p<0.001). Tibial varus was greater with greater femoral valgus (p<0.01). In both groups, the HKS angle was smaller with greater femoral valgus. DISCUSSION: Semi-automatic measurements on digitalized films enabled excellent reproducibility. Causes of error were related to limb rotation at acquisition. This study showed that genu varum worsens because of tibial wear followed by ligament distension, while for genu valgum, worsening predominantly results from femoral wear. The ankle joint line was nearly horizontal in one-third of the limbs, even when there was a major misalignment of the lower limb. The HKS angle was quite variable in both morphotypes, but was smaller with greater femoral valgus in both groups. CONCLUSION: Measuring all components involved in medial and lateral knee misalignment is very useful for understanding the morphotype of each individual knee before performing osteotomy or implanting a knee prosthesis.

[Horse breeding: genetic tests for the coat colors chestnut, bay and black. Results from a preliminary study in the Swiss Freiberger horse breed]. / Pferdezucht: Genetische Tests für die Fellfarben Fuchs, Braun und Schwarz. Ergebnisse einer ersten Untersuchung in der Schweizer Freibergerpferderasse.

Coat color played an important role during domestication and formation of breeds. Livestock breeders often had special preferences for particular color phenotypes because they believed them to be associated with performance or fitness traits. Socio-cultural reasons might have had an influence on color selection as well. Recently genetic tests on DNA level got available to genotype in any individual horse for basic horse coat colors (chestnut, bay, black). In particular, hidden carriers of the recessive chestnut and black allele are recognizable with these tests. A sample of 162 Franches-Montagnes horses from Switzerland was genotyped for the alleles for chestnut and black. The analysis of allele frequencies revealed a high prevalence of the chestnut allele and a low frequency of the black allele in this population. Rare colors are in demand on the market. The statistical analysis of 1369 offspring from five stallions indicate, that darker shades of basic color phenotypes (dark chestnut, dark bay) follow a recessive mode of inheritance in the Franches-Montagnes horse breed.

Biosynthesis of glycoproteins in human placenta: differential labeling of mannose and heterogeneity of oligosaccharide lipid intermediates.

The biosynthesis of lipid-linked oligosaccharides has been studied in first trimester human placentas. Tissue was pulsed with [2-3H]mannose, [1-3H]glucosamine, and [1-3H]galactose (for [3H]glucose incorporation). The lipid-linked oligosaccharides (OSL) were purified on DEAE-cellulose. After cleaving the lipid from OSL the oligosaccharides were purified by paper chromatography and borate high-voltage electrophoresis. Four major oligosaccharides with the composition Glc(0-3)Man9GlcNAc2 thus obtained were characterized enzymatically by digestion with endo-beta-N-acetylglucosaminidase H and alpha-mannosidase, and chemically by methylation, acetolysis, and Smith degradation. While identical Glc(1-3)Man9GlcNAc2 oligosaccharides have been isolated from other in vivo systems, the presence of Man9Glc2 is novel for human placenta. Furthermore, Man9GlcNAc2 is present in appreciable amounts in placenta. Second, one mannose in Man9GlcNAc2 had a significantly higher specific radioactivity than the other mannosyl residues of the Glc(0-3)Man9GlcNAc2 oligosaccharides. Third, the differential labeling in Man9GlcNAc2 and our pulse-chase studies indicate that Man9GlcNAc2 is not a major precursor of Glc3Man9GlcNAc2. The data also suggest that the ninth mannose, which has the highest radioactivity, may be incorporated in a different subcellular compartment and may serve as a regulatory step in the biosynthesis of lipid-linked oligosaccharides. A model is proposed which outlines possible multiple pathways of lipid-linked oligosaccharide biosynthesis in human placenta.

Biosynthesis of glycoproteins in human placenta: processing of oligosaccharides.

The processing of the high-mannose asparagine-linked oligosaccharides synthesized by first-trimester human placenta has been investigated. Tissue was pulsed for 1 h with [2-3H]mannose and chased for zero, 45, 90, and 180 min in media containing unlabeled mannose. Glycopeptides, prepared by Pronase digestion of the delipidated membrane pellets at each time point, were treated with endo-beta-N-acetylglucosaminidase-H to release the high-mannose asparagine-linked oligosaccharides. The largest major processing intermediate isolated was Glc1Man9GlcNAc, which was converted into Man9GlcNAc, and then into Man8GlcNAc, Man7GlcNAc, Man6GlcNAc, and Man5GlcNAc. There was also a minor pathway in which mannosyl residues were removed prior to the glucose. By carrying out the detailed structural characterization of the individual processing intermediates, it was possible to demonstrate that processing of the Man9GlcNAc to Man5GlcNAc proceeded by the nonrandom removal of the alpha 1,2-linked mannosyl residues. Specifically, of 12 possible sequences of removal of the four alpha 1,2-linked mannosyl residues present in Man9GlcNAc, first-trimester human placenta utilized only two of these in the processing of asparagine-linked oligosaccharides. It is suggested that the limited number of processing pathways reflects a high degree of specificity of these reactions in human placenta.

Muscle metabolism during exercise in diabetics and in obese during starvation.

The influence of exercise on forearm muscle metabolism was examined in 9 healthy subjects, in 16 diabetics and in 4 obese subjects during complete starvation. During exercise glucose uptake rose 7-8 fold in the controls. However, no increase of glucose uptake was observed in the other groups studied. Moreover, a glucose production from the working muscle took place in about 40 percent of both the diabetic patients and the starved obese subjects. The nonutilization of glucose during physical work in the diabetic like states was accompanied by a significantly diminished lactate output. The arterial concentration of FFA, glycerol beta-HOB and Acac was markedly elevated in the starved obese patients. The FFA-uptake at rest and during exercise, however, was not different from results of controls. Whereas an effux of beta-HOB has been observed during exercise, Acac uptake was increased in these patients. It is suggested that in maturity onset and starvation diabetes glycolysis is inhibited.

A modular analyzer system for double antibody radioimmunoassays.

The increasing number of determinations performed by radioimmunoassays necessitates rationalization of the procedures. An analyzer system has been developed in order to fully mechanize double antibody radioimmunoassays, which is essentially composed out of four independently working modules. The samples, in microliter vials, are carried in sample chains of up to 650 links. The first pipetting step is performed by syringes with displacement pistons. Additional reagents are rapidly added by an electronically controlled Hamilton repeating dispenser, which makes shaking procedures for mixing unnecessary. The bound/free separation is achieved discontinuously by use of Nuclepore-filters, which are carried in 3 inches distance (76 mm) by a 35 mm dark leader film. After covering the radioactive filter positions with an adhesive plastic foil from both sides, the film spool is directly inserted into a specially constructed gamma-counter. The results of the evaluation of the efficiency and of the precision of each module are presented in this paper.

[Simultaneous column chromatography for the automatic determination of hormones (author's transl)]. / Mechanisierte Hormon-Analytik mittels simultaner Säulenchromatographie

The automatic determination of hormone levels in serum by column chromatograhoic methods using a 25 channel peristaltic pump, allows the simultaneous chromatography of 25 samples. The different volumes which are necessary for the successive elution steps are set by the tubing size of the pump and by a preset switch clock. The eluates from the 25 columns are collected simultaneously in fractionated volumes which are also determined in the same electronic clock device. The assays so far adapted to this principle are reviewed: Serum thyroxine (competitive protein binding assay), T3-uptake test (dextran gel filtration), triiodothyronine (radioimmunoassay) and cortisol (competitive protein binding assay or radioimmunoassay). The main advantages of this procedure are increased frequency, improved specificity and standardization at lower costs for these methods. The principle of simultaneous column chromatography appears to be most suited for assays, which require various extraction steps prior to the determination of the hormone, since it allows extraction, specific protein binding and bound/free separation on only one column.