SLAC wrist in the absence of recognised trauma and CPPD

PURPOSE

This comparative cohort study was designed to determine whether non-traumatic SLAC wrist exists, and is associated with abnormal carpal bone kinematics (specifically, decreased lunate flexion).

METHODS

SLAC patients with no recognised history of upper extremity trauma were prospectively compared with an age-matched control group.

RESULTS

Thirty-five subjects (69 wrists), included 33 non-traumatic SLAC wrists and 36 control wrists. The non-traumatic SLAC group had significantly different radiographic kinematic analysis compared to the control group. Flexion of the asymptomatic non-degenerative wrist of the non-traumatic SLAC group was distributed 70% through the lunocapitate (LC) joint and only 30% through the RL joint (p < 0.05). Conversely, flexion was more evenly distributed in the control group (48% LC and 52% RL). The non-traumatic SLAC group had abnormal wrist kinematics even in the non-involved side.

CONCLUSIONS

This study suggests that non-traumatic SLAC does exist. We believe that non-traumatic SLAC begins with abnormal wrist kinematics and that the dorsal radiolunate ligament restricts lunate flexion but not scaphoid flexion, leading to increased SL angles and, with years, eventual attrition of the SL ligament.

A possible dual site of action for carbon monoxide-mediated chemoexcitation in the rat carotid body

High tensions of carbon monoxide (CO), relative to oxygen, were used as a tool to investigate the mechanism of chemotransduction. In an in vitro whole organ, rat carotid body preparation, CO increased sinus nerve chemoafferent discharge in the dark, an effect that was significantly reduced (by ca 70 %) by bright white light and by the removal of extracellular Ca(2+) from the superfusate or by the addition of either Ni(2+) (2 mM) or methoxyverapamil (100 microM). Addition of the P(2) purinoceptor antagonist pyridoxalphosphate-6-azophenyl-2',4'-disulphonic acid (50 microM) also significantly reduced the neural response to CO. In perforated patch, whole-cell recordings of isolated rat type I cells, CO induced a depolarisation of ca 11 mV and a decrease in the amplitude of an outward current around and above the resting membrane potential. Membrane conductance between -50 and -60 mV was significantly reduced by ca 40 % by CO. These effects were not photolabile and were present also when a 'blocking solution' containing TEA, 4-AP, Ni(2+) and zero extracellular Ca(2+) was used. In conventional whole-cell recordings, CO only decreased current amplitudes above +10 mV and was without effect around the resting membrane potential. These data demonstrate a direct effect of CO upon type I cell K(+) conductances and strongly suggest an effect upon a background, leak conductance that requires an intracellular mediator. The photolabile effect of CO only upon afferent neural discharge adds further evidence to a dual site of action of CO with a separate action at the afferent nerve terminal that, additionally, requires the permissive action of the neurotransmitter ATP.

Presynaptic action of adenosine on a 4-aminopyridine-sensitive current in the rat carotid body

1. Plasma adenosine concentration increases during hypoxia to a level that excites carotid body chemoreceptors by an undetermined mechanism. We have examined this further by determining the electrophysiological responses to exogenous adenosine of sinus nerve chemoafferents in vitro and of whole-cell currents in isolated type I cells. 2. Steady-state, single-fibre chemoafferent discharge was increased approximately 5-fold above basal levels by 100 microM adenosine. This adenosine-stimulated discharge was reversibly and increasingly reduced by methoxyverapamil (D600, 100 microM), by application of nickel chloride (Ni2+, 2 mM) and by removal of extracellular Ca2+. These effects strongly suggest a presynaptic, excitatory action of adenosine on type I cells of the carotid body. 3. Adenosine decreased whole-cell outward currents at membrane potentials above -40 mV in isolated type I cells recorded during superfusion with bicarbonate-buffered saline solution at 34-36 C. This effect was reversible and concentration dependent with a maximal effect at 10 microM. 4. The degree of current inhibition induced by 10 microM adenosine was voltage independent (45.39 +/- 2. 55 % (mean +/- s.e.m.) between -40 and +30 mV) and largely ( approximately 75 %), but not entirely, Ca2+ independent. 4-Aminopyridine (4-AP, 5 mM) decreased the amplitude of the control outward current by 80.60 +/- 3.67 % and abolished the effect of adenosine. 5. Adenosine was without effect upon currents near the resting membrane potential of approximately -55 mV and did not induce depolarization in current-clamp experiments. 6. We conclude that adenosine acts to inhibit a 4-AP-sensitive current in isolated type I cells of the rat carotid body and suggest that this mechanism contributes to the chemoexcitatory effect of adenosine in the whole carotid body.

Localization of the receptors for activated complement on the visceral epithelial cells by the human renal glomerulus by immunoenzymatic microscopy

Horseradish peroxidase-labeled IgG-anti-IgG immune complexes bearing activated third component of complement, C3, were used as indicator particles for the localization of the complement receptor in the human renal glomerulus. The HRP-labeled IgG-anti-IgG complexes were coated with activated C3 by exposing them to fresh human serum as a source of complement. This represents a more physiologic indicator particle for complement receptor-bearing structures than the synthetic immune complexes previously used. By light microscopy, the deposition of the complexes was restricted to the glomeruli. By transmission electron microscopy, the complexes were selectively associated with the surface of the visceral epithelial cells (podocytes). Complexes exposed to buffer alone or to heat-inactivated human serum failed to adhere to any of the renal structures examined.

Phospholipase activity of sea urchin sperm: its possible involvement in membrane fusion

Phospholipase activity of egg-water treated Arbacia punctulata and Lytechinus variegatus sperm was shown to result from the sequential action of phospholipase A and lysophospholipase. A transient burst of phospholipase A activity followed induction of the acrosome reaction with egg water. The time of appearance suggested an acrosomal localization of the enzyme. The peak activity of phospholipase A correlated with initiation of sperm-egg fusion, suggesting a role for sea urchin sperm phospholipase A in membrane fusion and/or egg activation during fertilization.