Effect of cyclic tensile strain on proliferation of synovial cells seeded onto synthetic ligament scaffolds--an in vitro simulation

OBJECTIVE

Cyclic tensile strain is pivotal to the remodeling of tissue induced in implants used in reconstruction of anterior cruciate ligaments whether these implants were of autogenous tissues or synthetic materials. However, this process is poorly understood. The objective of this study was to investigate the short and medium-term effect of cyclic tensile strain on the proliferation of synovial cells seeded on ligament scaffolds.

METHODS

206 ligament scaffolds made from plasma treated polyester with an ultimate tensile strength of 320 N were used in this study. Synovial cells were obtained from the metatarsophalangeal joints of 2 years old bovines. After expansion of these, they were seeded onto the scaffolds which were subjected, in a specialized apparatus, to a cyclic tensile strain of 4.5% at a frequency of 1 Hz. Initially, the strain was applied for a period of 4 h, which was subsequently reduced in further experiments to 1.0 h and 0.5 h. In further tests, strains of approximately 2.5%, 1% and 0.6% were applied for 1 h at the same frequency. In all the above tests, which were short-term tests (lasting for approximately 1 day), cell proliferation was investigated by the uptake of thymidine with which cells were labeled according to prescribed protocols. Cell proliferation was further examined with light microscopy after 5 weeks and the degree of fill of inter-yarn spaces was quantified for strain amplitudes of 1, 2.5 and 4.5%. Equal number of control (not strained) specimens was used at each time point.

RESULTS

In the 1-day experiments, for all durations of application of cyclic strain (exercise), the effect of strain on cell proliferation was inhibitory during the period of exercise and up to 18 h from its commencement, but was stimulatory 22-24 h afterwards. This stimulatory effect was maximal at an exercise period of 1 h. The study has also shown that there is a threshold for the amplitude of the strain (1%), at and below which cell proliferation was not significantly different from that observed in control specimens (P was <0.05 for all data). After 5 weeks of cyclic strain application, it was shown that the higher the amplitude of strain the larger was the area occupied by cells of the intra-yarn space.

CONCLUSION

Both the amplitude of cyclic strain and duration of its application affect the proliferation of synovial cells seeded on ligament scaffolds. The data should be useful when selecting or designing an implant, and when prescribing a postoperative exercise regime.

Features of the peritoneal covering of the lesser pelvis with special reference to stomata regions

Occasional reports describe various aspects of the fine morphology of the pelvic peritoneum, but its complete organ characteristics remain undefined. The peritoneal covering of the urinary bladder, rectum, uterus, uterine tube, ovary, broad ligament (BL) and testis in Wistar rats was examined by means of transmission and scanning electron microscopy (TEM, SEM). Unusually complicated relief and stomata between the cubic mesothelial cells characterized the surface of the BL. Deep, parallel furrows separated the wide longitudinal folds over the entire length of the uterine tube. The uterus and the ovary formed less numerous, shallow or extremely deep crypt-like invaginations, as well as serous villus-like or papilla-like evaginations. The flat cells were the predominant cell type over the BL, while the cubic mesothelium was the basic covering of the organs. Most of the cubic cells were located in the invagination of the submesothelial layer (SML). Such cells formed an almost smooth surface over the urinary bladder or formed larger areas of the rectum and the testis surfaces. Numerous microvilli, ciliae, round evaginations and complex lamellar bodies characterized their apical plasmalemma. In conclusion, the mesothelial heterogeneity is a stable feature of the lesser pelvis peritoneum, confirmed by TEM and SEM. The cubic mesothelium characterizes the organ peritoneum, while the BL plays the role of the parietal sheet, involving lymphatic units in the SML. The different types of contacts between the mesothelio-endothelial cells, large lymphatic vessels and occasional stomata are the usual components of the lymphatic units in norm, visible by TEM. Images of stomata, seen by SEM, demonstrate oval-shaped deep channel-like gaps surrounded by cubic mesothelium. The last data extend the evidence on stomata regions, which resemble the diaphragmatic ones. Clusters of cells (macrophages, mastocytes and Lymphocytes), small vessels (blood or lymphatic) and nerve fibers (unmyelinated and rare myelinated) form highly specialized complexes in the SML of the ovary, the uterus and the testis.

The salmon vertebral body develops through mineralization of two preformed tissues that are encompassed by two layers of bone

The teleost backbone consists of amphicoelous vertebrae and intervertebral ligaments, both of which include notochord-derived structures. On the basis of a sequential developmental study of the vertebral column of Atlantic salmon (Salmo salar L.) from the egg stage up to early fry stage (300-2500 day-degrees) we show that the vertebral body consists of four layers or compartments, two of which are formed through mineralization of preformed collagenous tissue (the notochordal sheath and the intervertebral ligament) and two of which are formed through ossification. The three inner layers have ordered lamellar collagen matrixes, which alternate perpendicularly from layer to layer, whereas the outer layer consists of cancellous bone with a woven matrix. The bone layers also differ in osteocyte content. In this study we describe the structural details of the layers, and their modes of formation. The results are compared with previous descriptions, and possible phylogenetic implications are discussed.

Bilateral spontaneous dislocation of intraocular lenses within the capsular bag in a retinitis pigmentosa patient

A 45-year-old man with retinitis pigmentosa (RP), who had undergone uneventful extracapsular cataract extraction (ECCE) in his right eye eight years previously, and phacoemulsification in his left eye six years previously, had spontaneously dislocated intraocular lenses (IOL) within the capsular bag in both eyes one month apart. We removed the dislocated IOLs, and performed anterior vitrectomy and scleral fixation of the new IOLs. Mild contraction of the capsular bags and uneven distribution of the zonular remnants' clumps along the equator of the capsules were found by scanning electron microscopic (SEM) examination. In this study, we propose the correlation between RP and zonular weakness. To our knowledge, this is the first case report of bilateral spontaneous dislocation of IOLs within the capsular bag of an RP patient.

MAGP-2 has multiple binding regions on fibrillins and has covalent periodic association with fibrillin-containing microfibrils

The interactions of microfibril-associated glycoprotein (MAGP)-2 have been investigated with fibrillins and fibrillin-containing microfibrils. Solid phase binding assays were conducted with recombinant fragments covering fibrillin-1 and most of fibrillin-2. MAGP-2, and its structure relative MAGP-1, were found to bind two fragments spanning the N-terminal half of fibrillin-1 and an N-terminal fragment of fibrillin-2. Blocking experiments indicated that MAGP-2 had a binding site(s) close to the N terminus of the fibrillin-1 molecule that was distinct from that for MAGP-1 and an additional, more central binding site(s) that may be shared by the two MAGPs. Immunogold labeling of developing nuchal ligament tissue showed that MAGP-2 had regular covalent and periodic (about 56 nm) association with fibrillin-containing microfibrils of elastic fibers in this tissue. Further analysis of isolated microfibrils indicated that MAGP-2 was attached at two points along the microfibril substructure, "site 1" on the "beads" and "site 2" at the "shoulder" of the interbead region close to where the two "arms" fuse. In contrast, MAGP-1 was located only on the beads. Comparison of the MAGP-2 binding data with known fibrillin epitope maps of the microfibrils showed that site 1 correlated with the N-terminal MAGP-2 binding region, and site 2 correlated with the second, more central, MAGP-2 binding region on the fibrillin-1 molecule. Of particular note, immunolabeling at site 2 was markedly decreased, relative to that at site 1, on extended microfibrils with bead-to-bead periods over 90 nm, suggesting that site 2 may move toward the beads when the microfibril is stretched. The study points to MAGP-2 being an integral component of some populations of fibrillin-containing microfibrils. Moreover, the identification of multiple MAGP-binding sequences on fibrillins supports the concept that MAGPs may function as molecular cross-linkers, stabilizing fibrillin monomers in folded conformation within or between the microfibrils, and thus MAGPs may be implicated in the modulation of the elasticity of these structures.

Guinea-pig interpubic joint (symphysis pubica) relaxation at parturition: underlying cellular processes that resemble an inflammatory response

BACKGROUND

At term, cervical ripening in coordination with uterine contractions becomes a prerequisite for a normal vaginal delivery. Currently, cervical ripening is considered to occur independently from uterine contractions. Many evidences suggest that cervical ripening resembles an inflammatory process. Comparatively little attention has been paid to the increased flexibility of the pelvic symphysis that occurs in many species to enable safe delivery. The aim of this study was to investigate whether the guinea-pig interpubic joint relaxation process observed during late pregnancy and parturition resembles an inflammatory process.

METHODS

Samples of pubic symphysis were taken from pregnant guinea-pigs sacrificed along gestation, parturition and postpartum. Serial sections of paraffin-embedded tissues were used to measure the interpubic distance on digitalized images, stained with Giemsa to quantify leukocyte infiltration and to describe the vascular area changes, or studied by the picrosirius-polarization method to evaluate collagen remodeling. P4 and E2 serum levels were measured by a sequential immunometric assay.

RESULTS

Data showed that the pubic relaxation is associated with an increase in collagen remodeling. In addition, a positive correlation between E2 serum levels and the increase in the interpubic distance was found. On the other hand, a leukocyte infiltration in the interpubic tissue around parturition was described, with the presence of almost all inflammatory cells types. At the same time, histological images show an increase in vascular area (angiogenesis). Eosinophils reached their highest level immediately before parturition; whereas for the neutrophilic and mononuclear infiltration higher values were recorded one day after parturition. Correlation analysis showed that eosinophils and mononuclear cells were positively correlated with E2 levels, but only eosinophilic infiltration was associated with collagen remodeling. Additionally, we observed typical histological images of dissolution of the connective tissue matrix around eosinophils.

CONCLUSION

The present study shows that a timely regulated influx of infiltrating leukocytes is associated with an extensive collagen remodeling process that allows the pubic separation for a normal delivery in guinea-pig. Thus, the findings in this study support the hypothesis that the guinea-pig pubic symphyseal relaxation at parturition resembles an inflammatory process.

Hindlimb unloading alters ligament healing

We investigated the hypothesis that hindlimb unloading inhibits healing in fibrous connective tissue such as ligament. Male rats were assigned to 3- and 7-wk treatment groups with three subgroups each: sham control, ambulatory healing, and hindlimb-suspended healing. Ambulatory and suspended animals underwent surgical rupture of their medial collateral ligaments, whereas sham surgeries were performed on control animals. After 3 or 7 wk, mechanical and/or morphological properties were measured in ligament, muscle, and bone. During mechanical testing, most suspended ligaments failed in the scar region, indicating the greatest impairment was to ligament and not to bone-ligament insertion. Ligament testing revealed significant reductions in maximum force, ultimate stress, elastic modulus, and low-load properties in suspended animals. In addition, femoral mineral density, femoral strength, gastrocnemius mass, and tibialis anterior mass were significantly reduced. Microscopy revealed abnormal scar formation and cell distribution in suspended ligaments with extracellular matrix discontinuities and voids between misaligned, but well-formed, collagen fiber bundles. Hence, stress levels from ambulation appear unnecessary for formation of fiber bundles yet required for collagen to form structurally competent continuous fibers. Results support our hypothesis that hindlimb unloading impairs healing of fibrous connective tissue. In addition, this study provides compelling morphological evidence explaining the altered structure-function relationship in load-deprived healing connective tissue.

Effects of stimulus with proinflammatory mediators on nitric oxide production and matrix metalloproteinase activity in explants of cranial cruciate ligaments obtained from dogs

OBJECTIVE

To evaluate the origin and degree of activity of nitric oxide (NO) and matrix metalloproteinase (MMP) in explants of cranial cruciate ligaments (CCLs) obtained from dogs and cultured with and without inflammatory activators.

SAMPLE POPULATION

Tissue specimens obtained from 7 healthy adult Beagles that were (mean +/- SD) 4.5 +/- 0.5 years old and weighed 12.5 +/- 0.8 kg.

PROCEDURE

The CCLs were harvested immediately after dogs were euthanatized, and specimens were submitted for explant culture. Cultures were stimulated by incubation with a combination of interleukin-1, tumor necrosis factor-alpha, and lipopolysaccharide, or they were not stimulated. Culture supernatants were examined for production of NO nitrite-nitrate metabolites (NOts) and activity of MMP Cultured specimens were evaluated by use of immunohistochemical analysis to detect activity of inducible NO synthase (iNOS).

RESULTS

All ligament explants produced measurable amounts of NOts. Stimulated cultures produced significantly more NOts after incubation for 24 and 48 hours, compared with nonstimulated cultures. Production of MMP in supernatants after incubation for 48 hours was significantly higher in stimulated cultures than in nonstimulated cultures. Cells with positive staining for iNOS were detected on all slides. Positively stained cells were predominantly chondroid metaplastic. There was a significant difference in intensity of cell staining between stimulated and non-stimulated cultures.

CONCLUSIONS AND CLINICAL RELEVANCE

Explant cultures of intact CCLs obtained from dogs produce iNOS-induced NO. Stimulation of chondroid metaplastic cells in CCL of dogs by use of inflammatory activators can increase production of iNOS, NOts, and MMP.

Ultrastructural characterization of the accessory lobes of Lachi in the lumbosacral spinal cord of the pigeon with special reference to intrinsic mechanoreceptors

The lumbosacral spinal cord of birds is unique among vertebrates in that segmentally organized accessory lobes protrude from the ventrolateral spinal cord into the vertebral canal. Recently, it has been suggested that these lobes may be part of an extralabyrinthine sense organ of equilibrium. For a better understanding of such a function, a complete analysis of the structural basis was performed by means of electron microscopy. The lobes consist of multipolar neurons, myelinated and unmyelinated axons, glia-derived glycogen cells, glial cells, and capillaries. The dorsal part of the lobe is covered by a loose mesh of pia mater. Ventrolaterally, an arachnoidal trabecle is in close contact with the lobe. Extracellular lacunae extend from the periphery deep into each lobe. The lacunae are separated from the subarachnoidal space by a loose mesh of processes of the glycogen cells with its basal lamina. The lacunae are filled by a network of processes of glycogen cells, glial cell, dendrites, and small axons. Both neuronal somata and dendrites are contacted by numerous axon terminals that form rather uniform synapses. Finger-like processes emerge from both the somata and the dendrites. The dendrites branch deeply into the extracellular lacunae and form lateral ramifications, which consist of narrow stalks with serially arranged bulbous portions, from which finger-like processes emerge. Finger-like processes are well-known elements in mechanotransduction. Glycogen cells and lacunae may contribute to transmission of hydrostatic pressure changes during movements of the body.

Computational modeling of ligament mechanics

This article provides a critical review of past and current techniques for the computational modeling of ligaments and tendons. A brief overview of relevant concepts from the fields of continuum mechanics and finite element analysis is provided. The structure and function of ligaments and tendons are reviewed in detail, with emphasis on the relationship of microstructural tissue features to the continuum mechanical hehavior. Experimental techniques for the material characterization of biological soft tissues are discussed. Past and current efforts related to the constitutive modeling of ligaments and tendons are classified by the particular technique and dimensionality. Applications of one-dimensional and three-dimensional constitutive models in the representation of the mechanical behavior of joints are presented. Future research directions are identified.

Lumbar intrathecal ligaments

A meticulous examination was performed on 56 vertebral columns from cadavers between 64 and 89 years of age. Identification of all contents within the dural sac was completed; however, the main focus was the cauda equina and lumbar region. In addition to scope dissection, radiographs and histological preparations were used to identify structures, tissue types, and any possible pathology. Discrete intrathecal ligamentous bands were observed in all cadavers examined. They were found randomly binding the dorsal nerve roots of the cauda equina to the dura. Occasional binding of the ventral nerve roots to the dorsal roots was observed. Histological examination demonstrated a dense collagen ligament varying between 0.13 and 0.35 microm in thickness and from 3 mm to 3.5 cm in length. The average number of ligaments found per cadaver was 18. These ligaments displayed a broad base attachment to the nerve root or dura of approximately 3 mm. Looping of the nerve roots associated with these ligaments was seen in one cadaver with a burst fracture. Electron microscopic studies of these ligaments demonstrated similarities to denticulate ligaments. It is suggested that the intrathecal ligaments represent remnants from fetal development of the denticulate ligaments.

Aging of the elastic and collagen fibers in the human cervical interspinous ligaments

BACKGROUND CONTEXT

The ligaments consist of collagen bands intermingled with elastic fibers that support hundreds of pounds of stress per square inch. In the spine the basic functional unit comprises vertebrae, intervertebral disc and ligament tissues. The interspinous ligaments with the function of limiting the spine flexion are exposed to a traumatic and degenerative process that promotes pain or instability. It has been shown that aging induces structural changes to capsular, fascial and ligamentous structures, mainly to the elastic and collagen fibers. However, the relative changes with age in elastic and collagen fibers have not been quantified.

PURPOSE

Examine the changes in the arrangement and amount of the elastic and collagen fibers of the human cervical interspinous ligament and attempt to correlate them with age.

STUDY DESIGN/SETTING

Histomorphometric analysis of ligament samples harvested during surgery.

PATIENT SAMPLE

We studied the dorsal portion of this ligament from 17 patients aged 16 to 69 years.

OUTCOME MEASURES

Fraction of collagen and elastic fibers with linear regression analysis correlating fraction versus age.

METHODS

The elastic and collagen fibers were identified by selective staining methods, and a blinded investigator using an image analysis system performed the histomorphometry.

RESULTS

There is an age-related progressive increase in collagen and mature and elaunin elastic fibers responsible to elasticity. However, these elastic fibers showed structural degenerative changes with aging. Furthermore, there is an age-related decrease of oxytalan elastic fibers responsible to resistance.

CONCLUSIONS

The aged interspinous ligament showed loss of elasticity that could alter the flexion limiting of the vertebral column.

Subfailure damage in ligament: a structural and cellular evaluation

Subfailure damage in ligaments was evaluated macroscopically from a structural perspective (referring to the entire ligament as a structure) and microscopically from a cellular perspective. Freshly harvested rat medial collateral ligaments (MCLs) were used as a model in ex vivo experiments. Ligaments were preloaded with 0.1 N to establish a consistent point of reference for length (and strain) measurements. Ligament structural damage was characterized by nonrecoverable difference in tissue length after a subfailure stretch. The tissue's mechanical properties (via stress vs. strain curves measured from a preloaded state) after a single subfailure stretch were also evaluated (n = 6 pairs with a different stretch magnitude applied to each stretched ligament). Regions containing necrotic cells were used to characterize cellular damage after a single stretch. It should be noted that the number of damaged cells was not quantified and the difference between cellular area and area of fluorescence is not known. Structural and cellular damage were represented and compared as functions of subfailure MCL strains. Statistical analysis indicated that the onset of structural damage occurs at 5.14% strain (referenced from a preloaded length). Subfailure strains above the damage threshold changed the shape of the MCL stress-strain curve by elongating the toe region (i.e., increasing laxity) as well as decreasing the tangential modulus and ultimate stress. Cellular damage was induced at ligament strains significantly below the structural damage threshold. This cellular damage is likely to be part of the natural healing process in mildly sprained ligaments.

Nuchal fibrocartilaginous pseudotumor: immunohistochemical and ultrastructural study of two cases

Two cases of nuchal fibrocartilaginous pseudotumor are reported. The lesions occurred in a 50-year-old woman and a 41-year-old man. From the clinical point of view, the absence of history of trauma in one case represents an unusual observation. Histologically, both lesions were similar to the 10 cases which have been previously described. They consisted of poorly defined, moderately cellular fibrocartilage nodules, and they lacked nuclear atypia and mitotic activity. Immunohistochemically, the lesions showed diffuse expression of vimentin and CD34. Mild expression of S-100 was limited to some chondroid cells. Desmin, alpha-smooth muscle actin, and CD99 (MIC2 gene product) were not expressed. Ultrastructurally, cells with features of fibroblasts and chondroblasts without any signs of myofibroblastic or myochondroblastic differentiation were found.

A light and electron microscopic study of ectopic tendon and ligament formation induced by bone morphogenetic protein-13 adenoviral gene therapy

OBJECT

Bone morphogenetic proteins (BMPs) are involved in the growth and development of many tissues, but it is their role in skeletal development and their unique ability to induce ectopic and orthotopic osteogenesis that have attracted the greatest interest. Expression of the BMP-13 gene is predominantly localized to hypertrophic chondrocytes in regions of endochondral bone formation during development, as well as in mature articular cartilage in the adult. In addition, the application of BMP-13 on a collagen carrier induces neotendon/neoligament formation when delivered subcutaneously or intramuscularly in rodents. The aim of the present study was to determine the histological and ultrastructural changes that occur after the intramuscular injection of a first-generation BMP-13 adenoviral vector.

METHODS

Athymic nude rats were injected with 3.75 x 10(10) plaque-forming units of adenovirus (Ad)-BMP-13 or Ad-beta-galactosidase in the thigh musculature, and the region was examined using light and electron microscopy at various time points between 2 days and 100 days postinjection. As early as 2 days after injection of Ad-BMP-13, progenitor cells were observed infiltrating between the transduced muscle fibers. These cells subsequently proliferated, differentiated, and secreted large amounts of collagenous extracellular matrix. By 100 days postinjection, the treated tissue displayed the histological and ultrastructural appearance of neotendon/neoligament, which was clearly demarcated from the surrounding muscle. Small foci of bone and fibrocartilage were also seen within the treated tissue. A short-term bromodeoxyuridine study also demonstrated rapid mesenchymal cell proliferation at the Ad-BMP-13 injection site as early as 48 hours postinjection. At all time points, the control AD-beta-gal injection sites were found to contain only normal muscle, without evidence of inflammation or mesenchymal cell proliferation.

CONCLUSIONS

The results of this study indicate that in the future the use of the BMP-13 gene may have therapeutic utility for the healing of tendon and ligament tears and avulsion injuries.

The superficial anulus fibrosus ligament. An incipient description of a separate ligament between the lumbar anterior longitudinal ligament and the intervertebral disc

A previously unknown ligament, the superficial anulus fibrosus ligament (SAFL), situated on the ventral part of the L5 intervertebral disc (ID) was observed and described from autopsy material. Twenty-eight cadaveric specimens from 12 black and 16 white persons aged 17-30 years were studied during routine forensic autopsies. The anterior longitudinal ligament was separated from the ID and the ventral part of the SAFL was visualized. The SAFL samples were removed, measured and studied with both conventional histology and examination by transmission electron microscopy. The SAFL was a completely separate ligament at the level of the L5-S1 ID situated between the anterior longitudinal ligament and the anulus fibrosus of the ID. The fibers of the ligament were vertically oriented. A difference in distance between the L5-S1 vertebral bodies ventrally was noted in the two groups studied (18.7 +/- 1.2 mm in the black vs. 15.2 +/- 1.0 mm in the white, p < 0.001), indicating a difference in the ventral thickness of the intervertebral disc. Also, there was a difference in the length (black: 17.7 +/- 1.6 mm vs. white: 14.1 +/- 1.1), thickness (black: 3.3 +/- 0.3 mm vs. white: 2.1 +/- 1.9), and the cross-sectional area (black: 58.2 +/- 6.7 mm(2) vs. white: 26.5 +/- 2.7 mm(2), p < 0.001) of the SAFL. Conventional light microscopy revealed no obvious differences. However, transmission electron microscopy revealed notably larger collagen fibril diameter in black than white subjects. In conclusion, the interbody distances were greater in the black group, indicating a greater intervertebral disc thickness, compared to that of the white. Furthermore, the SAFL was significantly longer and thicker in the black than in the white group. Albeit unsubstantiated, these race-specific macroscopic findings may have implications for understanding the etiology of various low back stress problems.

The osteochondral ligament: a fibrous attachment between bone and articular cartilage in Rana catesbeiana

The anuran epiphyseal cartilage shows a lateral expansion that covers the external surface of the bone, besides other features that distinguish it from the corresponding avian and mammalian structures. The fibrous structure that attaches the lateral cartilage to the bone was characterized in this work. It was designated osteochondral ligament (OCL) and presented two main areas. There was an inner area that was closer to the periosteal bone and contained a layer of osteoblasts and elongated cells aligned to and interspersed with thin collagen fibers. The thin processes of the cells in this area showed strong alkaline phosphatase activity. The outer area, which was closer to the cartilage, was rich in blood vessels and contained a few cells amongst thick collagen fibers. TRITC-phaloidin staining showed the cells of the inner area to be rich in F-actin, and were observed to form a net around the cell nucleus and to fill the cell processes which extended between the collagen fibers. Cells of the outer area were poor in actin cytoskeleton, while those associated with the blood vessels showed intense staining. Tubulin-staining was weak, regardless of the OCL region. The main fibers of the extracellular matrix in the OCL extended obliquely upwards from the cartilage to the bone. The collagen fibers inserted into the bone matrix as Sharpey's fibers and became progressively thicker as they made their way through the outer area to the cartilage. Immunocytochemistry showed the presence of type I and type III collagen. Microfibrils were found around the cells and amongst the collagen fibrils. These microfibrils were composed of either type VI collagen or fibrilin, as shown by immunocytochemistry. The results presented in this paper show that the osteochondral ligament of Rana catesbeiana is a complex and specialized fibrous attachment which guarantees a strong and flexible anchorage of the lateral articular cartilage to the periosteal bone shaft, besides playing a role in bone growth.

Spontaneous luxation of encapsulated intraocular lens onto the retina after a triple procedure of vitrectomy, phacoemulsification, and intraocular lens implantation

PURPOSE

To report the clinical and histological findings of a luxated intraocular lens (IOL) in the capsular bag.

METHODS

Review of a case.

RESULTS

Twenty-three months after a triple procedure of vitrectomy, phacoemulsification, and IOL implantation for diabetic vitreous hemorrhage and cataract, the encapsulated IOL spontaneously luxated. Scanning electron microscopy showed sparsely distributed anterior and equatorial zonules, with only a few posterior zonules on the surface of the removed capusular bag.

CONCLUSION

The absence of the anterior hyaloid membrane and posterior zonules and contraction of the lens capsule may cause dialysis of the zonules. Therefore, the anterior hyaloid membrane should be left in place in patients at low risk for the development of postoperative proliferation to maintain the long-term stability of the IOL.

Clear cell myomelanocytic tumor of the falciform ligament/ligamentum teres: a novel member of the perivascular epithelioid clear cell family of tumors with a predilection for children and young adults

The perivascular epithelioid cell family of tumors (PEComas), defined by their co-expression of melanocytic and muscle markers, includes angiomyolipoma, lymphangioleiomyoma, and clear cell "sugar" tumors of the lung, pancreas, and uterus. We present seven cases of a unique and previously unrecognized tumor of children and young adults, which represents a new addition to the PEComa group of tumors. Culled from three institutions over a 50-year period, all cases occurred in or immediately adjacent to the ligamentum teres and falciform ligament. Six patients were female and one male; their ages ranged from 3 to 21 years (median, 11 yrs). Tumor sizes ranged from 5 to 20 cm (median, 8 cm). All cases consisted of clear to faintly eosinophilic spindled cells arranged in fascicular and nested patterns. The cells had small but distinct nucleoli and low mitotic activity. Immunohistochemically, all cases were positive with antibodies to gp100 protein (HMB-45) and negative for S-100 protein. In three of the seven cases studied immunohistochemically, the tumors expressed smooth muscle actin, melan-A, microphthalmia transcription factor (MiTF), and myosin, but not desmin. No expression of the TSC2 gene product, tuberin, was seen in three cases. One case studied cytogenetically disclosed a t(3;10). Follow-up data, available in six of seven cases (median duration, 18 mos), showed five patients to be free of disease and one to have a radiographically presumed lung metastasis. We think these tumors comprise a new entity for which we propose the term "clear cell myomelanocytic tumor of the falciform ligament/ligamentum teres." The differential diagnosis of these tumors includes clear cell sarcoma of tendons and aponeuroses, leiomyosarcoma, and angiomyolipoma.

[Pectineal ligament of Cooper. Micromorphometric study]

The pectineal ligament is used in surgery as a support element in the treatment of groin hernias and female urinary stress incontinence. The question is to determine the anatomical characters that account for its strength. Three complementary approaches have been considered: an anatomical dissection study established the origin of the different fibers the ligament is composed of; a morphometric study determined the areas where the ligament is the thickest; and microscopic anatomy clearly showed the arrangement of the fibers. The pectineal ligament continues the near-by fibers fibrous elements, notably thanks to its ends. The latter are significantly thicker. At microscopic level, the regular layout of the pectineal ligament fibers accounts for its resistance.

Study of elastic fiber organization by scanning force microscopy

Elastic fibers of beef ligamentum nuchae were observed by atomic force microscopy and data compared with those obtained by conventional and freeze-fracture electron microscopy. Fresh isolated elastin fibers as well as thin sections of ligament fragments, which were fixed and embedded either in relaxed or in stretched conditions, were analysed. The results confirm that, at least in beef ligamentum nuchae, elastic fibers consist of beaded filaments which can be oriented by stretching in the direction of the force applied. Moreover, atomic force microscopy revealed that these beaded filaments are laterally connected by periodical bridges which become more pronounced upon stretching. The data clearly show that elastin molecules are organized in a rather ordered array, at least at the super-molecular level, and a depiction of the elastin organization in beef ligamentum nuchae is attempted.

Analysis of zonular-free zone and lens size in relation to axial length of eye with age

PURPOSE

To evaluate the anatomical relationships of the zonular-free zone (ZFZ) of the anterior capsule and crystalline lens diameter in relation to the axial length of the eye with age.

SETTING

Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea, and Storm Eye Institute, Medical University of South Carolina, Charleston, South Carolina, USA.

METHOD

Various ocular structures in 122 eyes obtained post-mortem were measured without prior preparation. The correlation between age, anterior-posterior (A-P) length and globe size, and diameters of the cornea, crystalline lens, and ZFZ were analyzed.

RESULTS

The average A-P globe length, and corneal, lens, and ZFZ diameters were 24.48, 11.67, 9.65, and 6.93 mm, respectively. There was no significant relationship between A-P length and globe size and corneal diameter in different age groups. The ZFZ size varied negligibly among age groups. There was a statistically significant correlation between lens diameter and age (correlation coefficient = 0.2647; P < .01) and lens diameter and A-P globe length (correlation coefficient = 0.3183; P < .001).

CONCLUSIONS

When choosing an intraocular lens, one should consider the patient's age and the A-P globe length. Six eyes (5%) showed unusual anterior insertion of zonular attachment, which reminds us to be prudent with a large paracentral capsulorhexis.

Functional and clinical anatomy of the posterior insertion of the human vocal ligament

The suggested methods of the formation of intubation granuloma as well as carcinoma invasion in the area of posterior vocal ligament insertion have been controversial. One reason for divergent opinions is possibly based on different judgements of morphology in this region. The present study analyzed structures of the vocal ligament and vocalis muscle insertion at the vocal process by means of histological, immunohistochemical and electron microscopic methods. Investigations were performed in three planes on the vocal cords of 22 men and 19 women (aged 21-97 years). Inside the insertion zone of the vocal ligament at the vocal process three structures could be distinguished: hyaline cartilage at the base of arytenoid cartilage, elastic cartilage at its apex and the posterior elastic nodule in front of them. No perichondrium could be seen around the elastic nodule. In elastic nodules type I and type III collagen fibrils as well as elastic fibers formed a scissor-like meshwork around large fibroblasts. The vocalis muscle inserted at the perichondrium in the lateral part of the arytenoid skeleton by short tendons. At the insertion zone blood vessels of the vocalis muscle penetrated the perichondrium and reached the cartilaginous matrix. At the beginning of osteogenesis, the blood vessels connected with intraosseous blood vessels of the arytenoid. Connective tissue cells of the insertion zone and extracellular matrix components formed by these cells fulfilled a biomechanical function by equalizing the different elastic moduli of tendon, cartilage or bone. The lack of perichondrium around the lengthened posterior elastic nodule made formation of intubation granulomas caused by perichondritis in this area impossible. Loosened perichondrium or periosteum in the area of the insertion of the vocalis muscle at the vocal process, ossification and associated vascularization of the arytenoid skeleton permitted invasion of carcinomas into the arytenoid.

Effects of training on collagen fibril populations in the suspensory ligament and deep digital flexor tendon of young thoroughbreds

OBJECTIVE

To determine the effect of a specific galloping exercise regimen on collagen fibril mass-average diameters (MAD) in the deep digital flexor tendon (DDFT) and suspensory ligament (SL) of young Thoroughbreds.

ANIMALS

12 Thoroughbred fillies, 21 +/- 1 (mean +/- SD) months old.

PROCEDURE

6 horses underwent a specific 18-month treadmill training program involving galloping exercise. The remaining 6 horses served as controls, undertaking low-volume walking exercise over the same period. Sections were excised from the midpoint of the DDFT and SL, and small strips were dissected from central and peripheral locations for each structure. Fibril diameters were measured from micrographs of transverse ultrathin sections, using a computerized image analysis program. An MAD value was calculated for the central and peripheral regions of the DDFT and SL for each horse. Values for both regions were compared between exercised and control horses.

RESULTS

The MAD did not change significantly with exercise for either the DDFT or the SL.

CONCLUSION

Loading of the DDFT as a result of this exercise regimen was not sufficient to stimulate collagen fibril hypertrophy, in keeping with current data that indicate this tendon, compared with the SL and superficial digital flexor tendon (SDFT), is subjected to low loads. Microtrauma, in terms of reduction in fibril MAD, may have occurred in the SL at a site different from that sampled. Another possibility is that, between the trot and the gallop, loading of the SL does not increase to the same extent as that of the SDFT.

Immunohistochemical and ultrastructural localization of MP78/70 (betaig-h3) in extracellular matrix of developing and mature bovine tissues

MP78/70 is a matrix protein, with 78-kD and 70-kD isoforms, which was initially identified in bovine tissue extracts designed to solubilize elastin-associated microfibrils. Peptide analysis has shown that MP78/70 is closely related to the human protein, betaig-h3. In the present study an antibody raised to a synthetic betaig-h3 peptide was shown specifically to identify MP78/70 in purified form and in bovine tissue extracts. This is consistent with MP78/70 and betaig-h3 being the bovine and human forms, respectively, of the same protein. The antibody was further affinity-purified on MP78/70 bound to Sepharose and used to localize the protein in a range of bovine tissues. Immunofluorescence showed that MP78/70 was localized to collagen fibers in tissues such as developing nuchal ligament, aorta and lung, and mature cornea; to reticular fibers in fetal spleen; and to capsule and tubule basement membranes in developing kidney. No general localization to elastic fibers was observed. The staining pattern in most tissues more closely resembled that of Type VI collagen, which occurs as collagen fiber-associated microfibrils, than that of fibrillin-1, a component of elastin-associated microfibrils. However, MP78/70 appeared to be less widely distributed than Type VI collagen. Immunoelectron microscopy showed that MP78/70 was predominantly found in loose association with collagen fibers in most tissues examined and was also located on the surface of the capsule basement membrane in developing kidney. Double labeling experiments indicated that MP78/70 is co-distributed with Type VI collagen microfibrils located in these regions. In some elastic tissues significant immunolabel was detected in regions of interface between collagen fibers and fibrillin-containing microfibrils of adjacent elastic fibers, and at the outer margins of the latter structures. Overall, the evidence points to MP78/70 having a bridging function, perhaps in association with Type VI collagen microfibrils, linking or stabilizing the interaction between interstitial collagen fibrils and other matrix structures, including some basement membranes and elastin-associated microfibrils.