Mildly oxidized low-density lipoproteins decrease early production of interleukin 2 and nuclear factor kappaB binding to DNA in activated T-lymphocytes

Activated T-lymphocytes are found early in atherosclerosis lesions, but little is known about their role. Oxidized low-density lipoproteins (oxLDLs) are considered to be involved in the pathogenesis of the lesions, and we have previously demonstrated that oxLDLs inhibit not only interleukin (IL)-2-receptor expression on the surface of in vitro-activated T-lymphocytes but also their proliferation. We have now investigated the effect of oxLDLs on blast differentiation, on IL-2 synthesis and on the activation of the nuclear factor kappaB (NF-kappaB) system in activated lymphocytes. Mildly oxLDLs (50 and 100 microgram/ml) decreased the number of lymphoblasts and the level of IL-2 concentration in the culture supernatants after activation of lymphocytes by phytohaemagglutinin and PMA+ionomycin. The inhibition of IL-2 production was observed in the CD3(+) T-lymphocyte cytoplasm as early as 4 h after activation by PMA+ionomycin. The study of NF-kappaB showed that oxLDLs led to a decrease of activation-induced p65/p50 NF-kappaB heterodimer binding to DNA, whereas the presence of the constitutive nuclear form of p50 dimer was unchanged. This was correlated with an unchanged level of the active form of the cytosolic inhibitor protein IkappaB-alpha. Taken together, these observations suggest that the immunosuppressive effect of oxLDLs might operate via a dysregulation of the T-lymphocyte activation mechanisms.

Degeneration and regeneration in rabbit peripheral nerve with long-term nerve cuff electrode implant: a stereological study of myelinated and unmyelinated axons

Selective and dynamically co-ordinated functional electrical stimulation (FES) of paralysed/paretic limbs in upper motor neuron lesioned people depends on optimal contact at the neural interface. Implanted nerve cuff electrodes may form a stable electrical neural interface, but may also inflict nerve damage. In this study the immediate and long-term effects of cuff implantation on the number and sizes of myelinated and unmyelinated axons have been evaluated with unbiased stereological techniques. Cuff electrodes were implanted in rabbit tibial nerves just below the knee joint, and the stereological analyses were carried out 2 weeks and 16 months after implantation. Myelinated axons were analysed at standardised levels proximal to, underneath, and distal to the cuff; unmyelinated axons underneath the cuff. A 27% loss of myelinated axons was found underneath and distal to the nerve cuff 2 weeks post surgery. All axonal sizes were equally lost except for the very smallest. At 16 months post surgery the number of myelinated axons was restored to control values at both levels. Except for the presence of regenerative sprouts at 2 weeks post surgery, no changes in the number or sizes of unmyelinated axons were revealed at either 2 weeks or 16 months post surgery. Our study demonstrates that implanted cuff electrodes may cause an initial loss of myelinated axons but with subsequent regeneration.

Flow cytometric characterization of proliferating natural killer lymphocytes from bone marrow donors in the mixed lymphocyte reaction

Detection of natural killer (NK) cells in the mixed lymphocyte reaction (MLR) was investigated by flow cytometry and cytotoxicity toward the K562 cell line. Peripheral blood mononuclear cells (PBMCs) from normal individuals were stimulated with either lymphoblastoid cell lines (LCLs) or PBMCs. This approach allowed the following observations: 1) after stimulation by LCLs, the percentage of NK cells increased concomitantly with the level of cytotoxicity, in contrast to when PBMCs were used as stimulators; 2) anti-interleukin-2 monoclonal antibody strongly inhibited NK proliferation in the MLR, but antibody to interferon gamma did not; and 3) purified NK cells were unable to proliferate against LCLs. All these data suggest that NK cells induced by LCL stimulators depend on T cells to proliferate in the MLR. Flow cytometric detection of NK cells in the MLR was also used on cryopreserved PBMCs from 31 bone marrow donors, because it has been reported that an enhanced donor NK cell activity was correlated with the development of graft-versus-host disease after HLA-identical sibling bone marrow transplantation. NK cell proliferation under LCL stimulation was intense and varied greatly among the donors tested. However, no statistical correlation was observed between LCL-induced donor NK cell proliferation in the MLR and the occurrence of graft-versus-host disease after bone marrow grafting.

Increased urinary crosslink levels in aseptic loosening of total hip arthroplasty

The diagnosis of aseptic loosening in total hip arthroplasty is predominantly based on clinical and radiographic evaluation. Loosening is usually associated with increased bone resorption at the interface. In this study we wanted to evaluate the diagnostic value of bone markers in aseptic loosening. We compared 50 patients with proven component loosening during surgery with 50 age-, sex-, and implant-matched patients without clinical or radiological signs of loosening. We measured serum markers of bone formation (bone-specific alkaline phosphatase, osteocalcin [OC], procollagen type I propeptides) and bone resorption (collagen n-telopeptide [NTX], deoxypyridinoline [DPYD], pyridinoline [PYD]). We found significantly increased levels of NTX, DPYD, PYD, and OC in the loosening group. The other markers showed no significant difference between both groups. We conclude that determination of urinary crosslinks may offer a new and valuable diagnostic method in the detection of aseptic loosening in total hip arthroplasty.

Familial congenital horizontal gaze paralysis and kyphoscoliosis

Congenital horizontal gaze paralysis is a rare disorder which may be associated with severe scoliosis of early onset. We present the clinical findings of two sisters with this syndrome. The additional finding of a unique pericentric inversion of chromosome 12 is considered to be incidental. Every child with congenital horizontal gaze paralysis should be evaluated for a possibly associated scoliosis. If present, a diagnosis of this presumably autosomal recessive syndrome can be made with appropriate treatment and genetic counseling.

Characterization of lymphocyte subpopulations in periapical lesions by flow cytometry

The mechanisms by which the bacterial root-canal infection leads to periapical bone destruction (cysts or granulomas) are not yet well understood. Previous works have shown elements of an active immune response in the lesions. In the present study, flow cytometry was used to improve the characterization of immune cells. Semiquantitative immunohistochemical analysis showed the presence of plasma cells, macrophages and B and T cells. The simultaneous use of several antibodies in flow cytometry allowed a more precise phenotype of the lymphocytes. The cysts displayed an abundance of B lymphocytes at the same time as a relative scarcity of CD8+ cells. CD4+ lymphocytes were the dominant lymphocyte population in most cases. A small number of gamma delta T lymphocytes and natural killer cells was found. These preliminary results show that flow cytometry may be used to characterize immune cells from inflamed tissue and opens the possibility for further functional studies.

[Prenatal ultrasound diagnosis of children with dysmelia]

Since 1979 prenatal ultrasonography is a screening method in Germany. The examination of head, thorax and femur is now established as a routine method.

AIM OF THE STUDY

The evaluation of the effectiveness and the consequences of an early prenatal diagnosis of foetal limb deficiencies.

METHOD

From 1989-1994 we had 403 children with 207 minor or 196 major limb deficiencies. Questionnaires were sent to those 196 parents of children with major diseases 134 cases (68%) of children with limb deficiencies could be analysed. The average age of the mother at birth was 27.5 years and the age of the father was 30.5 years.

RESULTS

61 children had deficiencies of the upper limb. another 61 of the lower limbs and 12 had combined defects of the limbs. The mothers had 5.6 (1-15) prenatal ultrasounds examinations. In 63% (n = 82) these were performed by the obstetric practitioners, in 30% in departments of obstetrics and 7% in a university hospital. In 5.2% only, the limb deficiency was diagnosed antenataly.

CONCLUSION

If there are any unclear findings the women should be sent to a centre of prenatal diagnostics. In cases of congenital deficiencies of the limbs there is the possibility] for the parents to combined to combined consultation of the obstetrician, the human genetic and the orthopaedic to plan the treatment and talk about all consequences.

Optimization of a flow cytometric method for the simultaneous measurement of cell surface antigen, DNA content, and in vitro BrdUrd incorporation into normal and malignant hematopoietic cells

We have designed an assay for the simultaneous measurement of cell surface phenotype, S-phase fraction, and DNA content by single laser instrumentation for the purpose of determining the labeling index (LI), duration of S-phase (Ts), and the potential doubling time (Tpot) of leukocyte subpopulations. The procedure was optimized with regard to: mode of bromodeoxyuridine (BrdUrd) incorporation, selection of suitable leukocyte differentiation antigens (LDAs) as well as PE-conjugated monoclonal antibodies (MoAbs) against myeloid cells, overnight permeabilization and fixation (paraformaldehyde 1% and 0.05% Nonidet P40), DNase I treatment (250 Kunitz units), concentration of FITC-conjugated anti-BrdUrd MoAb (dilution 1:5), and DNA staining with 7-amino-actinomycin (7-AAD) (10 microg/ml). We validated this assay by measuring LI, Ts, and Tpot repeatedly in four leukemic cell lines and found these to be stable (coefficients of variation (CV): 0.06, 0.13, and 0.08, respectively). Finally, we employed the assay on different leukocyte preparations from normal donors (including purified CD34 + cells) and patients with malignant myeloid disorders, and we concluded that it will yield valuable data regarding the cell cycle kinetics of subsets of leukocytes in heterogeneous mixtures of hematopoietic cells.

Mildly oxidized low-density lipoproteins suppress the proliferation of activated CD4+ T-lymphocytes and their interleukin 2 receptor expression in vitro

Activated T-lymphocytes are present in early atherosclerotic lesions where they may interact with oxidized low-density lipoproteins (oxLDLs). In this study the non-specific effect of oxLDLs on the activation of T-cells in vitro was investigated. LDLs were oxidized by UV irradiation and characterized by a low level of lipid peroxidation and only slight apolipoprotein B modification. Peripheral blood lymphocytes from normal individuals were stimulated in vitro with the polyclonal activator phytohaemagglutinin in the presence of various doses of LDLs and oxLDLs. LDLs enhanced the proliferation of peripheral blood lymphocytes at doses up to 100 microg/ml but were inhibitory at 200 microg/ml, whereas low doses of oxLDLs (over 10 microg/ml) inhibited the proliferation. OxLDLs also inhibited the proliferative responses of an alloreactive CD4+ T-cell line immortalized by Herpes virus saimiri and an influenza haemagglutinin-specific CD4+ T-cell clone. Viability tests using Trypan Blue exclusion or expression of Apo2.7, an apoptosis marker, did not indicate any significant cell death at doses up to 100 microg/ml oxLDL. At this concentration, cell-cycle analysis showed an accumulation of cells at the G1/S interface in the CD4+ cell clone, without significant DNA fragmentation. The expression of the activation antigen CD25 on T-lymphocytes (on phytohaemagglutinin-activated T-cells and on CD4+ T-cell clone), requisite to the commitment of activated T-cells from G1 phase to S phase, was also inhibited by oxLDLs whereas expression of other activation antigens such as CD69 and HLA-DR was unchanged. In conclusion, these data show that mildly oxidized LDLs inhibit the proliferation and CD25 expression of activated T-lymphocytes and suggest that oxLDLs may slow down the T-cell response in atherosclerotic lesions.

Periprosthetic mineralization around cementless total hip endoprosthesis: longitudinal study and cross-sectional study on titanium threaded acetabular cup and cementless Spotorno stem with DEXA

In a prospective longitudinal study over 2 years and a separate cross-sectional study more than 5 years after operation, we analyzed periprosthetic bone mineral density (BMD) after cementless total hip arthroplasty (THA) (press-fit cementless Spotorno stem, Mecron threaded acetabular cup) by dual-energy X-ray absorptiometry (DEXA). BMD was analyzed in a longitudinal prospective study (n = 53 patients: 29 women, 24 men) and in a separate cross-sectional study (n = 23 patients: 13 women, 10 men) with good clinical outcome (Merle d' Aubigne score > 12). Regions of interest were defined according to Gruen (ROI 1-7) and as netto average ROI (NETAVG I) for the periprosthetic femur, and according to De Lee and Charnley (ROI I-III) and as NETAVG II for the periprosthetic acetabulum. BMD during follow-up was compared with immediate postoperative values of the affected limb. Mean precision error (CV%) was 2.6 +/- 0.5% for ROI 1-7 and 1.3 +/- 0.9% for ROI I-III. BMD significantly decreased in the periprosthetic femur and acetabulum during the first 3 months after operation. At the femur, BMD (NETAVG I) for women and men, respectively, was 92.4% and 87.5% at 6 months, then 89.4% and 96.2% at 2 years. ROIs around the proximal stem showed the lowest absolute values and decreased most during follow-up (to 79.9% ROI 1 and 68.2% ROI 7, respectively). Mineralization around the cup (NETAVG II), respectively, amounted to 81.1%, 82.6% at 6 months, then 80.1% and 93.8% at 2 years. The medially placed ROI II demineralized most (respectively, 72.1% and 76.7%). More than 5 years after THA, BMD in the femur showed little change, but decreased significantly to 76.4% and 79.1%, respectively, around the cup (NETAVG II). DEXA is a useful method for analyzing changes of mineralization around cup and stem of cementless THA. The results reflect the different stress on the periprosthetic bone after implantation of THA in defined ROIs, supporting earlier reported good clinical results of the Spotorno stem and increased loosening rate of threaded acetabular cups after 5 years.

Thanatophoric dysplasia type I: new radiologic, morphologic, and histologic aspects toward the exact definition of the disorder

A comprehensive seven-step study on THANATOPHORIC DYSPLASIA without cloverleaf skull (TD Type I) was carried out postmortem on three aborted fetuses of 19, 26-27, and 34 weeks and one preterm neonate of 35 weeks gestation, respectively. The characteristic x-ray configuration of the spine in TD Type I presenting with H-, U- or reversed U-shape vertebrae were shown to correlate with the inclination or reclination of the vertebral bodies within a kyphotic or lordotic segment. The bowing of the tubular bones in TD Type I is explained by a diminished mechanical stability that is causally related to a specific cartilage structure. The perichondral spurs are defined by their morphologic structure, and their origin is attributed to a normal perichondral ossification in the presence of an impaired enchondral ossification. Impairment of enchondral ossification was more evident in the periphery than in the center of the metaphyses leading to a tongue-shaped osseous cone directed toward the epiphysis. The perichondral spurs and the linguiform enchondral growth plate resulted in a three-phase maple leaf-like contour of the metaphyses of tubular bones and acetabular roof. The nature of the perichondral fibrous bands, the fibrovascular bundles, and the fibrovascular bands of the growth plate and their significance in atypical ossification processes are discussed in detail. It is suggested that the diminished longitudinal growth of the skeleton is caused by a reduced mitotic activity of cartilage cells in the proliferative zone leading to a reduction of cell numbers in the columnar zone transversely oriented spongiosa bars resulting from desmal ossification of the metaphyseal fibrovascular structures.

The different appearance of the oculodentodigital dysplasia syndrome

We report on two families with the oculodentodigital (ODD) dysplasia syndrome, also called Meyer-Schwickerath syndrome. It represents a rare disorder characterized by eye and facial abnormalities causing a unique facial appearance. The phenotype of the young patients resembles those of identical twins. We found syndactyly mostly at the hands and, additionally, characteristic phalangeal aberrations, defects in teeth enamel, and trichosis. In the one family, the ODD dysplasia syndrome seemingly originated in a new mutation. The affected child was treated surgically in our clinic (syndactyly separation). In the other family, three patients (grandmother, mother, and granddaughter) were subjects of syndactyly separation. The aim of our surgeries was to separate the webbed fingers so there would be a normal spread and to improve the function and appearance of fingers. The ODD dysplasia syndrome correlates with the Hallermann-Streiff syndrome, or oculomandibulodyscephaly, which is characterized by a typical skull shape (brachicephaly with frontal brossing), a bird-like face, and eye abnormalities (congenital cataracts and microphthalmia).

[Use of new biochemical markers in diagnosis of aseptic hip endoprosthesis loosening]

Aseptic loosening of endoprosthesis is the most important problem in total hip arthroplasty. The diagnosis of aseptic loosening is based on anamnesis, the clinical findings, the radiography and scintigraphy. Despite the multitude of diagnostic possibilities it is still a problem to get an exact and early diagnosis. The process of loosening in the bone interface always leads to a change of bone structure of the surrounding bone tissue. In a prospective study we measured biochemical markers of bone metabolism in serum and urine to evaluate a possible change occurring parallel to endoprotheic loosening. 37 patients with severe signs of loosening (later intraoperatively confirmed) and 30 patients without any clinical or radiological signs of loosening (control group) were induced. Gender, age and model of endoprosthesis were similar in both groups. Parameters of bone formation (osteocalcin, alkaline phosphatase, procollagen I C-terminal extension peptide) and bone resorption (Cross-linked n-terminal telopetide) were measured. The cross-linked n-terminal telopetide (NTX) was significant increased in the loosening group (p < 0.001). Of the measured bone formation markers only osteocalcin showed a significantly higher level in patients with endoprosthetic loosening (p < 0.002). All other measured parameters of the bone metabolism showed no significant differences between the both groups. Our results show, that biochemical markers can provide relevant information of endoprosthesic loosening. We are now analysing in a prospective longitudinal study whether these parameters are also suitable to detect early endoprosthetic loosening.

[Mechanism of action of hyaluronic acid in gonarthrosis of both knee joints in a right/left comparison. Study with dynamometry, oxygen partial pressure, temperature and Lequesne score]

In a controlled prospective randomized study we evaluated the effectiveness of intraarticular injected hyaluronic acid regarding the changes in the parameters dynamometry, synovial oxygen partial pressure, intraarticular temperature and the knee joint function (Lequesne score). We examined 18 patients with osteoarthritis in both knee joints (Kellgren classification II or III according to x-ray) in right/left comparison. The evaluated parameters were measured before and after a 5-week treatment phase with 5 intraarticular injections (one injection per week). With regard to the efficacy results changes in dynamometric measurement for flexion and extension (for all angular velocities) and Lequesne-score indicate a marked improvement after treatment with hyaluronic acid. The differences between treated and untreated knee were significant. In extension the p-value was 0.0008 and in flexion p = 0.0015. The p-value of the Lequesne-index between the verum and control group was p = 0.0002. After treatment values for oxygen pressure were higher than at baseline and for the intraarticular temperature a small decrease at the end of the treatment phase was documented. The intraarticular injection of hyaluronic acid is effective and safe in the treatment of patients with gonarthrosis. The treatment resulted in a functional improvement of the knee joint and had a good pain-lowering effect in patients suffering from gonarthrosis.

Middle-term results of threaded acetabular cups. High failure rates five years after surgery

We report our results using three different threaded acetabular components (Mecring A, Mecring B and Weill) in 715 hips with a follow-up of between one and ten years (median: 99.1, 56.5, 38.3 months, respectively). All cups were implanted with one type of cementless stem. The clinical results were good or acceptable in about 70% of the hips, but signs of loosening with radiolucency and/or migration were found in 10.1%. Radiological evidence of loosening did not correlate significantly with the clinical outcome. Pain was not a reliable indicator of loosening and its absence sometimes allowed severe osteolysis to develop. Twenty-five hips were revised (3.5%) for aseptic loosening of the acetabular component. Kaplan-Meier estimates of the cumulative rate of failure showed a rapid increase five years after the initial operation, but no significant correlation with gender, age or weight. The high rate of failure indicates that further use of these acetabular components cannot be recommended. Annual radiographs are required to assess osteolysis even if the patients are free from pain.

Influence of synchronous and sequential stimulation on muscle fatigue

In acute experiments the sciatic nerve of the rat is electrically stimulated to induce fatigue in the medial Gastrocnemius muscle. Fatigue tests are carried out using intermittent stimulation of different compartments (sequential) or a single compartment (synchronous) of the sciatic nerve. The activation of different compartments is achieved by dividing nerve fibres into subbundles and placing them in separate grooves in a multigroove electrode. The aim of the investigation is to quantify the effect of sequential contra synchronised stimulation in reducing muscle fatigue, with no overlap between compartments. Overlap between two compartments is calculated using the combined and individual forces from both compartments. Sequential stimulation of two and three compartments is investigated. There is a significant decrease of fatigue in sequential stimulation compared to synchronous. After 2 min of intermittent stimulation the force time level is significantly increased in sequential stimulation, than in synchronous stimulation. The rate of force time decrease is significantly slower in sequential stimulation than in synchronous stimulation. With sequential stimulation it takes significantly longer before the maximal force time is reached than with synchronous stimulation.

Dominant clones in immortalized T-cell lines from rheumatoid arthritis synovial membranes

Transformation of human T cells by herpesvirus saimiri allows the production of an unlimited number of T cells which express a functional T-cell receptor. In this study we transformed four T-cell lines derived from rheumatoid arthritis synovial membranes. The transformed T cells were mainly CD4+ and expressed the phenotype of activated T cells. They were grown for more than 1 year in the absence of mitogen or feeder cells, and three of them could be maintained without exogenous IL-2. The presence of viral DNA in the transformed cells was shown by in situ hybridization with a probe from the H-DNA region of the virus. No infectious virus could be recovered from the transformed cells. The relative proportion of the 24 different Vbeta families between the four transformed lines showed variations that increased with time. In the two T-cell lines transformed at an early stage of culture, the Vbeta2 family was maintained at about 10%. The dominant Vbeta2 clones that previously have been characterized in the patient were found in all transformed T-cell lines. We have thus shown the feasibility of obtaining transformed T cells from synovial membranes. They contain the dominant clones that are considered of potential importance for the disease, permitting further functional studies.

MIDDLE-TERM RESULTS OF THREADED ACETABULAR CUPS

We report our results using three different threaded acetabular components (Mecring A, Mecring B and Weill) in 715 hips with a follow-up of between one and ten years (median: 99.1, 56.5, 38.3 months, respectively). All cups were implanted with one type of cementless stem.

The clinical results were good or acceptable in about 70% of the hips, but signs of loosening with radiolucency and/or migration were found in 10.1%. Radiological evidence of loosening did not correlate significantly with the clinical outcome. Pain was not a reliable indicator of loosening and its absence sometimes allowed severe osteolysis to develop. Twenty-five hips were revised (3.5%) for aseptic loosening of the acetabular component. Kaplan-Meier estimates of the cumulative rate of failure showed a rapid increase five years after the initial operation, but no significant correlation with gender, age or weight.

The high rate of failure indicates that further use of these acetabular components cannot be recommended. Annual radiographs are required to assess osteolysis even if the patients are free from pain.

Microsatellites in the HLA region: on overview

Microsatellites are repeats of a DNA base motif (1-6 bp, mostly CA repeats) up to 100 times; they are distributed regularly all over the genome. Many of them are polymorphic and their high polymorphism is based upon a variable number of repeats. They are widely used for genetic mapping, linkage analysis, population genetics, evolutionary studies and in forensic medicine. Such markers have also been described in the HLA region since 1991, and a growing interest in their potential applications is being expressed. The aims of this review are: 1) to outline the presently available information from literature and molecular databases concerning 53 microsatellites in the HLA region (localization, type of repeat, number of alleles, heterozygosity, primers used for amplification); 2) to address the question of technical pitfalls when using such markers; 3) to discuss specific features such as their mutation rate (10 (-3) to 10 (-6), which is higher than that reported for HLA genes, and their linkage disequilibrium with HLA alleles; 4) to present an integrated map of microsatellites and genes of this region; and 5) to provide a synopsis of their different applications in HLA-related fields (disease studies, population genetics, recombination point studies, HLA region mapping, transplantation) along with perspectives for future use. Although some HLA region microsatellites have already been applied to the analysis of more than 10 diseases, it is now evident that their use in population genetics and the determination of genomic compatibility in bone marrow transplantation represent growing areas of application.

[Patellar hypertension syndrome--nomenclature, diagnosis and therapy]

PURPOSE

Complaints in the area of the patella have been abundantly described in the literature. However, a uniform nomenclature with regard to either diagnosis or therapy does not exist.

METHODS

With the help of a standardized measuring method (intrapatellar pressure measurement and provocation test), it is possible to describe and classify patellar pain. An intrapatellar pressure increase over 25 mmHg and/or a positive provocation test defines the term of Patella Hypertension Syndrome.

RESULTS

Within a prospective study we carried out a special intraosseous drilling in 20 cases with the typical symptoms of the Patella Hypertension Syndrome. The drilling, which was carried out via the Hoffa fat body from distal, resulted in a distinct alleviation of symptoms in all cases and even in a complete absence of pain in most cases. This phenomenon was objectified by a pressure-check-up after 6 weeks, 6 months and 1 year following the drilling. In all 20 cases so far examined a decrease of between 40-70% of the original pressure level was achieved. In all cases the postoperative artificial pressure increase (provocation test) of the intraosseous pressure did not lead to the typical pain symptoms.

CONCLUSION

We therefore have a relatively minor operation at our disposal enabling us to achieve an impressive therapeutic success, in cases where conventional treatment was neither causal nor successful.

[The Göttinger minipig as an animal model in hip endoprosthesis. Anatomy, anesthesia, operation results]

The Göttingen mini swine is a good experimental animal. The electrolytes and the bone healing rate is comparable to human. The weight of the animals should be 30-45 kg. All surgery is performed under endotracheal general anaesthesia without any complication. There is minimal blood loss because blood pressure is only 40/80 mmHg. We used the anterolateral approach. The feature peculiarity of this animal model are: 1. Skin incision should start 10 cm cranial to the tail and should be curved. 2. The osteotomy of the head is V-shaped in maximal external rotation. 3. The acetabulum is prepared with a 23.5 mm reamer. 4. The stem should be implanted first. After completion of the preliminary test operations, 10 animals were operated in the described standard manner. During one year follow-up there was only one radiological cup-loosening.

Polarizing and reflective coatings based on half-wave layer pairs

The majority of the layers of a multilayer optical coating typically have optical thicknesses equal to one quarter of the appropriate wavelength of radiation. Replacing this constraint with the stipulation that a pair of adjacent layers should have a total optical thickness of one half of a wavelength introduces a significant new component of design flexibility while having a minimal impact upon the desired optical properties of the film. Taking a matrix approach, we derive a general expression for the reflectance of a periodic thin-film structure that is based on layers of two different materials of arbitrary thickness. This result is applied to highly reflective coatings at normal incidence and to off-normal polarizing coatings. Specific results involving HfO(2)/SiO(2) films and TiO(2)/SiO(2) films are displayed. We discuss how the thickness of the high-index layers may be reduced to increase damage thresholds. We also show a mirror design that is effective not only at lambda = 1.06 mum but also at the frequency-doubled wavelength.

[Intra-articular oxygen partial pressure measurements under functional conditions]

Oxygen partial pressure is directly related to the vascularisation of different tissues. Different investigations in tissue (muscle, kidney, brain, heart, bone etc.) proved this correlation. The development of a special flexible microcatheter named Licox enables us to do measurements of intraarticular oxygen partial pressure under physiological and pathological conditions for the first time. The aim of this study was to examine the influence of different knee joint stresses on the intraarticular oxygen partial pressure under normal conditions and in osteoarthritis. The results showed that the different exercise patterns influence the intraarticular oxygen partial pressure. Patients with osteoarthritis showed a lower increase of the intraarticular oxygen partial pressure compared to the control group. This phenomenon is directly correlated to degree velocity of the isokinetic exercises. The same findings occur under ergometric conditions. The method permits functional, intraarticular in vivo measurements under different exercise patterns. For the very first time we were able to measure the influence of the joint movement on the intraarticular process of nutrition under physiological and pathological conditions. Different therapy concepts in osteoarthritis can be evaluated directly in vivo for the first time.