[Bone marrow edema--an early form of femur head necrosis]

We examined 15 patients (16 hips) with painful hips whose radiographs were either normal (n = 9) or showed a minimal decrease in radiodensity (n = 7). The available bone scintigrams of 9 cases were positive. T1-weighted images visualised a diffuse signal loss of the bone marrow in all hips, with various extensions in the head, neck, and intertrochanteric area. These regions were hyperintensive on T2-weighted images. Focal anomalies were not seen in any of the cases. All patients underwent core decompression treatment. Histology of 13 hips confirmed not only the presence of bone marrow oedema but of bone changes corresponding to those of avascular necrosis. Follow-up examinations with MR after core decompression showed normal signal intensity in all cases. Magnetic resonance represents a viable diagnostic tool for identifying bone marrow oedema. Due to our histological results bone marrow oedema should be included in the differential diagnosis as an early stage of necrosis of the hip.

Application of scanning transmission electron microscopy to the study of biological structure

The scanning transmission electron microscope provides structural and chemical information of a specimen at atomic-scale resolution and complements conventional transmission electron microscopy techniques. Mass measurements can now be performed routinely on a wide range of molecular and supramolecular structures using elastically scattered electrons. Recent progress in the acquisition and analysis of electron energy-loss spectroscopy data indicates that the scanning transmission electron microscope is an efficient tool for mapping the chemical composition of biological samples.

[Femur head necrosis and bone marrow edema syndrome in pregnancy]

MR examinations were performed in 9 patients suffering from severe pain of the hip during the third trimenon without any relief after birth. Pathologic signal changes could be observed in 11 hips (oedema in the region of the femoral head and neck (n = 8); avascular necrosis of the femoral head surrounded by bone marrow oedema (n = 3)). In 7 hips a relatively rapid decrease of the oedema following core decompression was demonstrated. Focal necrosis, however, did not show any changes. In two patients, treated conservatively, markedly delayed healing was evident. MR imaging is the modality of choice for early diagnosis as well as follow-up of therapy of the bone marrow oedema syndrome or avascular necrosis and can be performed already during pregnancy.

Plasmodium yoelii in mice: antigen reactivity of CD4- and CD8-bearing T cells

Mice infected with Plasmodium yoelii (265 BY, a nonlethal strain) after recovering from parasitemia become resistant to reinfection. In the present study, we have attempted to define the role of T cell subsets in primary vs secondary P. yoelii infection. We have evaluated the in vivo effects of selective depletion of each subset of T cells on the course of infection and also investigated the in vitro expansion of each subset in response to homologous antigen. Depletion of CD4- or CD8-bearing T cells did not result in reappearance of parasitemia in animals cured from primary infection. However, 25% of reinfected animals treated with anti-CD4 mAb, but not with anti-CD8 mAb, displayed a low level (2 to 3%) of parasitemia late in the secondary infection. The splenocyte response to P. yoelii antigen or to T-cell mitogens was impaired during patient infection, even in the 25% of CD4-depleted animals with low parasitemia. A markedly high lymphocyte reactivity to antigen was observed in mice recovered from primary infection, and this was enhanced in animals exposed to a challenge infection. In the case of animals cured from primary infection, a marked decrease in antigen-induced in vitro lymphocyte proliferation occurred in CD8-depleted but not in CD4-depleted animals when total splenic cell populations were assayed. Although less dramatic, a significant diminution in antigen reactivity was observed also with T-rich populations in CD8-depleted animals. In contrast, there was no such decrease in CD4-depleted mice. Treatment of resistant animals which were challenged with a second infection, with anti-CD4 or anti-CD8 mAbs, resulted in a significant decrease in the proliferative response to antigen by both T-rich and total cell populations. In the secondary infection, the T-rich cell populations from CD8-depleted mice responded better to P. yoelii antigen than the total cell populations, indicating an inhibitory role on the expansion of CD4+ T cells of B cells or their product(s) which were removed during T cell enrichment. The results of our study suggest that CD8-bearing T cells were more reactive in the primary infection. In the secondary infection, although both CD8+ and CD4+ T cells were antigen reactive, the latter T cell subset appeared to play a superior role in controlling the parasitemia.

[Muscle function of the thigh 10 years following a malignant bone tumor and implantation of a tumor prosthesis in the knee]

To objectify the muscle function of 5 patients ten years after implantation of a tumor endoprosthesis of the knee simultaneous muscle force and IEMG was recorded. The muscular activity in the operated leg was found to be reduced for the extension muscles (8-20%) and for the flexion muscles (28-52%) when comparing to the normal leg. Knee extension of the operated leg resulted from the function of the rectus femoris muscle. During normal exercise in daily life all patients were not handicapped und some of them did sport.

Two-dimensional crystallization of the light-harvesting complex from Rhodospirillum rubrum

Homogeneous detergent-solubilized B873 light-harvesting complexes from a carotenoid-less mutant of the purple non-sulfur bacterium, Rhodospirillum rubrum G9, were reassembled spontaneously into two-dimensional (2D) hexagonal arrays during extensive and controlled dialysis. As the complexes contain only 1 to 2 mol phospholipid per mol alpha beta dimer, the arrays formed by a self assembly process are primary due to protein-protein interactions. The hexagonal lattices were analyzed by negative stain electron microscopy and digital image processing. They exhibited a unit cell size of 12.3 nm, in close agreement with the particle diameter of the active photo-unit in native chromatophore membranes. The unit cell contains a central 5 nm stain-filled depression, embraced by a ring with an outer diameter of 10 nm.

Human erythrocyte band 3. Solubilization and reconstitution into two-dimensional crystals

Various polyoxyethylene alkylethers were used to extract integral proteins from human erythrocyte membranes. The solubilization power of these detergents and the oligomerization of solubilized band 3 were studied. Sodium dodecyl sulfate/polyacrylamide gel electrophoresis revealed that short-chain detergents induced oligomers larger than the band 3 dimer. In contrast, after solubilization with long-chain detergents, the predominant band on SDS-containing gels was the monomeric band 3. Oligomerization in short-chain detergents occurred preferentially at room temperature whereas monomeric band 3 prevailed at 4 degrees C. Consistent with these results, negative stain electron microscopy of solubilized isolated band 3 showed larger complexes with short-chain detergents than with long-chain detergents. Cu2+/o-phenanthroline-induced crosslinking had no effect on size or shape of band 3 particles. Despite their rather heterogeneous dimensions, octylpolyoxyethylene-solubilized band 3 complexes assembled into two-dimensional trigonal lattices (a = b = 11 (+/- 0.5) nm) in the presence of dimyristoyl phosphatidylcholine. The unit cell exhibited a pronounced stain-filled region surrounded by three elongated morphological subunits. Each subunit most likely represents a band 3 dimer. Freeze-drying/metal-shadowing of reconstituted lattices revealed one large elevation per unit cell protruding from an otherwise smooth surface.

Bone-marrow oedema syndrome and transient osteoporosis of the hip. An MRI-controlled study of treatment by core decompression

Bone-marrow oedema syndrome (BMOS) of the hip gives a characteristic MRI pattern, in association with severe pain, non-specific focal loss of radiological density and a positive bone scan. In our MRI-controlled study, nine patients with non-traumatic BMOS in ten hips all had core decompression. Bone-marrow pressure measurements and intraosseous venography in five cases showed pathological values. All patients had immediate relief of pain, with return of MRI signals to normal after three months. Regular review was continued for at least 24 months with serial clinical radiological and MRI assessment. At a mean follow-up of 33 months all patients remained free of pain with normal radiographs and MR scans. The histological evaluation of undecalcified sections obtained from eight core decompressions confirmed the presence of bone-marrow oedema, with necrotic and reparative processes involving bone and marrow similar to those of early avascular necrosis but with no evidence of 'osteoporosis'. These findings support the assumption that BMOS may be the initial phase of non-traumatic avascular necrosis. In most patients BMOS will have a self-limiting course, but the duration of symptoms may be reduced by core decompression treatment.

The inactive form of recA protein: the ‘compact’ structure

When recA protein is enzymatically inactive in vitro, it adopts a more compact helical polymer form than that of the active protein polymerized onto DNA in the presence of ATP. Here we describe some aspects of this structure. By cryo-electron microscopy, a pitch of 76 A is found for both the self-polymer and the inactive complex with ssDNA. A smaller pitch of 64 A is observed in conventional electron micrographs. The contour length of complexes with ssDNA was used to estimate the binding stoichiometry in the compact complex, 6 +/- 1 nt/recA. In addition, the compact structure was observed in vivo in Escherichia coli: inclusion bodies produced upon induction of recA expression in an overproducing strain have a fibrous morphology with the structural parameters of the compact polymer.

Two distinct levels of gap junction assembly in vitro

The in vitro assembly of crystalline gap junctions from detergent-solubilized sheep lens fiber cell pore complexes in the presence of endogenous lipid is a two-step process. "Mini"-gap junctions containing about 10 pore complexes assembled within 12 hr of dialysis. The removal of detergent appeared to be the sole factor required to reach this level of assembly. Further growth to micrometer-sized crystalline gap junctions required cleaved connexin, MgCl2, elevated dialysis temperature, and dialysis for 3-5 days. Molecular interactions between adjacent pore structures laterally in the membrane are vital for the second phase of assembly but appear to be of minor importance for the formation of mini-gap junctions. Parallels exist between structural aspects of gap junction assembly in vitro and the 2-D crystallization of membrane proteins in general.

Bone marrow edema of the hip: MR findings after core decompression

Magnetic resonance imaging is an extremely sensitive technique for evaluation of bone marrow changes at an early stage of avascular necrosis (AVN) of the hip. We therefore examined 11 painful hips whose clinical symptoms led us to suspect idiopathic AVN. The radiographs of all of these either were normal or demonstrated a minimal decrease in radiodensity. Magnetic resonance demonstrated diffuse signal loss of the bone marrow at short TR/TE images of the femoral head in all hips, with various extensions in the head, neck, and intertrochanteric area. These regions turned iso- to hyperintense on long TR/TE images compatible with bone marrow edema (BME). Focal abnormalities characteristic for AVN were not seen in any of the cases. Radionuclide studies performed in six cases were positive. All patients underwent core decompression treatment. Hydrostatic bone marrow pressure measurement and intraosseous venography were positive in five cases when measured. Histology available in eight cases confirmed the presence of BME. Furthermore, the bone changes corresponded to those of early AVN. Follow-up examinations after core decompression with MR showed normal signal intensity in all cases. Magnetic resonance represents a viable diagnostic tool for BME and can monitor the therapeutic success of core decompression. Whether BME of the femoral head constitutes a distinct transient syndrome or represents an early form of AVN is controversial at present. Our findings support those who believe that BME may represent an initial stage of idiopathic AVN.

Assembly of 2-D membrane protein crystals: dynamics, crystal order, and fidelity of structure analysis by electron microscopy

Membrane protein reconstitution into two-dimensional (2-D) ordered arrays is described. The assembly of 2-D crystals may be modeled as a two-step process: the membrane protein is first integrated in the lipid bilayer and then crystallized by removal of excess detergent or lipid and/or by precipitating agents. Lipid-detergent, protein-detergent, and lipid-protein interactions are critical during the first step, while lipid-protein and protein-protein interactions dominate events in the second step. The evidence supporting this model results from quasielastic light scattering analyses and electron microscopy of different lipid-detergent systems and reconstitution experiments with Escherichia coli porin OmpF, Phormidium laminosum photosystem I reaction centers, and integral membrane proteins of mammalian lens fiber cells.

2D crystallization: from art to science

The techniques as well as the principles of the 2D crystallization of membrane and water-soluble proteins for electron crystallography are reviewed. First, the biophysics of the interactions between proteins, lipids and detergents is surveyed. Second, crystallization of membrane proteins in situ and by reconstitution methods is discussed, and the various factors involved are addressed. Third, we elaborate on the 2D crystallization of water-soluble proteins, both in solution and at interfaces, such as lipid monolayers, mica, carbon film or mercury surfaces. Finally, techniques and instrumentations that are required for 2D crystallization are described.

Has negative staining still a place in biomacromolecular electron microscopy?

Transmission electron microscopy of proteins has provided molecular- and in a few cases near-atomic-resolution structural information. In this review, we critically evaluate the potential and the limitations in obtaining molecular resolution, particularly with negatively stained specimens, and put these into perspective with cryomicroscopy of unstained frozen-hydrated and sugar-embedded preparations.

Histamine-induced bronchoconstriction in conscious guinea pigs measured by strain-gauge transduction. A new method

A new objective method for measuring histaminedihydrochloride-induced bronchoconstriction in conscious guinea pigs has been developed. The aim of the present work was to investigate whether identical results could be obtained when the clinical observation of conscious guinea pigs with symptoms of respiratory distress (bronchoconstriction) was compared to an objective measuring technique of this parameter. An evaluation of the repeatability of the method was made and the respiration frequence (fR) and histaminedihydrochloride challenge concentration were compared to see whether there was a correlation between the two. Consequently, an apparatus was built that allowed simultaneous recording of breathing pattern and clinical observation of the animal being challenged. The breathing pattern was recorded by a strain-gauge transducer, connected to a measuring bridge, and the curves obtained on a jet ink x-y writer were used for calculating changes in duration of expiratory phase (Te) and fR. During the attacks of histaminedihydrochloride-induced bronchoconstriction a significantly prolonged Te could be calculated from the respiration curves. A high degree of agreement was found between this objective measure and clinically observed respiratory distress. The repeatability of the method was comparable to that of corresponding methods used for histaminedihydrochloride challenge in man. No obvious correlation was found between changes in fR and histaminedihydrochloride challenge concentration.

Subunit stoichiometry and three-dimensional arrangement in proteasomes from Thermoplasma acidophilum

The proteasome or multicatalytic proteinase from the archaebacterium Thermoplasma acidophilum is a 700 kDa multisubunit protein complex. Unlike proteasomes from eukaryotic cells which are composed of 10-20 different subunits, the Thermoplasma proteasome is made of only two types of subunit, alpha and beta, which have molecular weights of 25.8 and 22.3 kDa, respectively. In this communication we present a three-dimensional stoichiometric model of the archaebacterial proteasome deduced from electron microscopic investigations. The techniques which we have used include image analysis of negatively stained single particles, image analysis of metal decorated small three-dimensional crystals after freeze-etching and STEM mass measurements of freeze-dried particles. The archaebacterial and eukaryotic proteasomes are almost identical in size and shape; the subunits are arranged in four rings which are stacked together such that they collectively form a barrel-shaped complex. According to a previous immunoelectron microscopic investigation, the alpha-subunits form the two outer rings of the stack, while the two rings composed of beta-subunits, which are supposed to carry the active sites, are sandwiched between them. Each of the alpha- and beta-rings contains seven subunits; hence the stoichiometry of the whole proteasome is alpha 14 beta 14 and the symmetry is 7-fold. Image simulation experiments indicate that the alpha- and beta-subunits are not in register along the cylinder axis; rather it appears that the beta-rings are rotated with respect to the alpha-rings by approximately 25 degrees. In contrast to some previous reports we have not been able to find stoichiometric amounts of RNA associated with highly purified proteolytically active proteasome preparations.

[Sympathetic reflex dystrophy. Effectiveness of physical therapy treatment of Sudeck's syndrome]

To investigate the impairment of patients with reflex sympathetic dystrophy syndrome (RSDS) and to establish the effectiveness of two physiotherapeutic regimens in the treatment of this entity, 54 RSDS patients were examined clinically, radiologically and scintigraphically an average of 112 days after the triggering event. The patients were assigned to either of two treatment groups in accordance with the results of preliminary scintigraphic examinations. After physiotherapy comprising exercises and cryotherapy either with or without galvanic stimulation, a significant therapeutic effect on clinical and scintigraphic parameters was found in both treatment groups. Scanning, in combination with clinical diagnostic measures proved a valuable tool in the diagnostic evaluation, selection of treatment and follow-up in patients with RSDS.

MR contrast arthrography (MRA) in osteochondrosis dissecans

Osteochondrosis dissecans (OCD) is a lesion that characteristically affects the articular cartilage and subchondral bone with the potential of fragmentation and separation. Exact assessment of cartilaginous and subchondral bony changes is mandatory for the planning of adequate treatment. Therefore, we examined 25 knees using spin echo (SE) and gradient echo (GE) sequences on a 1.5 T superconducting unit prior to and following intraarticular administration of 40 ml of a 2 mmol/L Gd-DTPA solution (MR arthrography). For evaluation (staging) a modified Clanton and DeLee scheme was employed. Verification by arthroscopy or arthrotomy was available in 24 cases. A correct diagnosis of OCD with regard to its type prior to intraarticular injection of Gd-DTPA was possible in 39.3% using T1-weighted SE sequences and in 57.4% on GE sequences. After intraarticular administration of Gd-DTPA, the rate of correct diagnoses improved to 92.9% on T1-weighted SE sequences and 100% on GE sequences. Magnetic resonance arthrography appears to be helpful for the exact assessment of the articular cartilage overlying OCD lesions as well as for the differentiation between partial and complete separation of cartilaginous or osteocartilaginous fragmentations.

Two-dimensional crystals of Escherichia coli maltoporin and their interaction with the maltose-binding protein

We have reconstituted Escherichia coli maltoporin into phospholipid membranes at low lipid-to-protein ratios to produce two-dimensional crystals of this membrane protein. Electron microscopy of negatively stained membranes showed three different types of arrays, two of them hexagonal and the third rectangular, all diffracting to approximately (2 nm)-1. Furthermore, we have core-constituted maltoporin with the maltose-binding protein from E. coli, a soluble periplasmic protein that has been proposed to interact with maltoporin. One of the hexagonal arrays was found to bind maltose-binding protein molecules in a regular way, while the maltose-binding protein binding sites were not accessible in the other crystal forms. Difference maps from averaged decorated arrays and undecorated controls showed three symmetry-related maltose-binding protein binding sites per maltoporin trimer, of which not more than one is likely to be occupied at a given time. Using multivariate statistical analysis to select similar unit cells of the decorated maltoporin array, we have obtained a map showing the rough outline of a maltose-binding protein molecule interacting with the pore formed by a maltoporin trimer.

Ubiquitous soluble Mg(2+)-ATPase complex. A structural study

We have performed a detailed structural analysis of the soluble Mg(2+)-ATPase complex purified from Xenopus laevis ovary, which is an abundant and ubiquitous homo-oligomeric protein complex located in the nucleus and in the cytoplasm, belonging to a novel multigene-family of putative Mg(2+)-ATPases. Enzyme activity staining after non-denaturing polyacrylamide gel electrophoresis revealed that Mg(2+)-ATPase activity of the native protein is dependent on oligomerization and could not be detected in dissociated subunits. For the native protein a sedimentation coefficient of 15.3 S and a corresponding relative molecular mass of 612,000 was determined by analytical ultracentrifugation and a relative molecular mass of 590,000 was estimated from scanning transmission electron microscopy, supporting our previous conclusion that the oligomer comprises six 97,000 Mr subunits. Conventional electron microscopy of negatively stained specimens revealed the Mg(2+)-ATPase complex to be a hexagonal molecule in its favoured "end-on" projection and a double-banded molecule in its "side-on" projection (approx. 12 nm diameter; approx. 9 nm height). In addition, dimerized complexes could be observed in negatively stained specimens, yielding pronounced hexameric images and four-banded images in their end-on and side-on orientations, respectively (approx. 12 nm diameter; approx. 18.5 nm height). Two-dimensional (2D = mono-molecular) crystals have been produced from the dimerized complexes by the negative staining carbon film technique. Hexagonal crystals with a p6 plane group symmetry were obtained from molecules in their end-on orientation and longitudinal arrays with a p2 symmetry from complexes in their side-on orientation. A low-resolution molecular model of the native protein, derived from averages of these two 2D crystals, is presented. From our results we propose oligomerization as an inherent structural principle of organization for this whole newly defined Mg(2+)-ATPase multigene-family, that includes such seemingly diverse functionally defined proteins as mammalian and yeast "vesicle fusion" and "peroxisome assembly" proteins and the product of the yeast cell cycle gene CDC48.