Markers for DNA damage are induced in the rat colon by the Alternaria toxin altertoxin-II, but not a complex extract of cultured Alternaria alternata

Mycotoxins produced by Alternaria spp. act genotoxic in cell-based studies, but data on their toxicity in vivo is scarce and urgently required for risk assessment. Thus, male Sprague-Dawley rats received single doses of a complex Alternaria toxin extract (CE; 50 mg/kg bw), altertoxin II (ATX-II; 0.21 mg/kg bw) or vehicle by gavage, one of the most genotoxic metabolites in vitro and were sacrificed after 3 or 24 h, respectively. Using SDS-PAGE/Western Blot, a significant increase of histone 2a.X phosphorylation and depletion of the native protein was observed for rats that were exposed to ATX-II for 24 h. Applying RT-PCR array technology we identified genes of interest for qRT-PCR testing, which in turn confirmed an induction of Rnf8 transcription in the colon of rats treated with ATX-II for 3 h and CE for 24 h. A decrease of Cdkn1a transcription was observed in rats exposed to ATX-II for 24 h, possibly indicating tissue repair after chemical injury. In contrast to the observed response in the colon, no markers for genotoxicity were induced in the liver of treated animals. We hereby provide the first report of ATX-II as a genotoxicant in vivo. Deviating results for similar concentrations of ATX-II in a natural Alternaria toxin mixture argue for substantial mixture effects.

Heparin-binding motif mutations of human diamine oxidase allow the development of a first-in-class histamine-degrading biopharmaceutical

Background

Excessive plasma histamine concentrations cause symptoms in mast cell activation syndrome, mastocytosis, or anaphylaxis. Anti-histamines are often insufficiently efficacious. Human diamine oxidase (hDAO) can rapidly degrade histamine and therefore represents a promising new treatment strategy for conditions with pathological histamine concentrations.

Methods

Positively charged amino acids of the heparin-binding motif of hDAO were replaced with polar serine or threonine residues. Binding to heparin and heparan sulfate, cellular internalization and clearance in rodents were examined.

Results

Recombinant hDAO is rapidly cleared from the circulation in rats and mice. After mutation of the heparin-binding motif, binding to heparin and heparan sulfate was strongly reduced. The double mutant rhDAO-R568S/R571T showed minimal cellular uptake. The short α-distribution half-life of the wildtype protein was eliminated, and the clearance was significantly reduced in rodents.

Conclusions

The successful decrease in plasma clearance of rhDAO by mutations of the heparin-binding motif with unchanged histamine-degrading activity represents the first step towards the development of rhDAO as a first-in-class biopharmaceutical to effectively treat diseases characterized by excessive histamine concentrations in plasma and tissues.

Funding

Austrian Science Fund (FWF) Hertha Firnberg program grant T1135 (EG); Sigrid Juselius Foundation, Medicinska Understödsförening Liv och Hälsa rft (TAS and SeV).

Beneficial Metabolic Effects of TREM2 in Obesity Are Uncoupled From Its Expression on Macrophages

Obesity-induced white adipose tissue (WAT) hypertrophy is associated with elevated adipose tissue macrophage (ATM) content. Overexpression of the triggering receptor expressed on myeloid cells 2 (TREM2) reportedly increases adiposity, worsening health. Paradoxically, using insulin resistance, elevated fat mass, and hypercholesterolemia as hallmarks of unhealthy obesity, a recent report demonstrated that ATM-expressed TREM2 promoted health. Here, we identified that in mice, TREM2 deficiency aggravated diet-induced insulin resistance and hepatic steatosis independently of fat and cholesterol levels. Metabolomics linked TREM2 deficiency with elevated obesity-instigated serum ceramides that correlated with impaired insulin sensitivity. Remarkably, while inhibiting ceramide synthesis exerted no influences on TREM2-dependent ATM remodeling, inflammation, or lipid load, it restored insulin tolerance, reversing adipose hypertrophy and secondary hepatic steatosis of TREM2-deficient animals. Bone marrow transplantation experiments revealed unremarkable influences of immune cell-expressed TREM2 on health, instead demonstrating that WAT-intrinsic mechanisms impinging on sphingolipid metabolism dominate in the systemic protective effects of TREM2 on metabolic health.

Human diamine oxidase cellular binding and internalization in vitro and rapid clearance in vivo are not mediated by N-glycans but by heparan sulfate proteoglycan interactions

Human diamine oxidase (hDAO) rapidly inactivates histamine by deamination. No pharmacokinetic data are available to better understand its potential as a new therapeutic modality for diseases with excess local and systemic histamine, like anaphylaxis, urticaria or mastocytosis. After intravenous administration of recombinant hDAO to rats and mice, more than 90% of the dose disappeared from the plasma pool within 10 min. Human DAO did not only bind to various endothelial and epithelial cell lines in vitro, but was also unexpectedly internalized and visible in granule-like structures. The uptake of rhDAO into cells was dependent on neither the asialoglycoprotein-receptor (ASGP-R) nor the mannose receptor (MR) recognizing terminal galactose or mannose residues, respectively. Competition experiments with ASGP-R and MR ligands did not block internalization in vitro or rapid clearance in vivo. The lack of involvement of N-glycans was confirmed by testing various glycosylation mutants. High but not low molecular weight heparin strongly reduced the internalization of rhDAO in HepG2 cells and HUVECs. Human DAO was readily internalized by CHO-K1 cells, but not by the glycosaminoglycan- and heparan sulfate-deficient CHO cell lines pgsA-745 and pgsD-677, respectively. A docked heparin hexasaccharide interacted well with the predicted heparin binding site 568RFKRKLPK575. These results strongly imply that rhDAO clearance in vivo and cellular uptake in vitro is independent of N-glycan interactions with the classical clearance receptors ASGP-R and MR, but is mediated by binding to heparan sulfate proteoglycans followed by internalization via an unknown receptor.

Histone deacetylase 1 (HDAC1): A key player of T cell-mediated arthritis

Rheumatoid Arthritis (RA) represents a chronic T cell-mediated inflammatory autoimmune disease. Studies have shown that epigenetic mechanisms contribute to the pathogenesis of RA. Histone deacetylases (HDACs) represent one important group of epigenetic regulators. However, the role of individual HDAC members for the pathogenesis of arthritis is still unknown. In this study we demonstrate that mice with a T cell-specific deletion of HDAC1 (HDAC1-cKO) are resistant to the development of Collagen-induced arthritis (CIA), whereas the antibody response to collagen type II was undisturbed, indicating an unaltered T cell-mediated B cell activation. The inflammatory cytokines IL-17 and IL-6 were significantly decreased in sera of HDAC1-cKO mice. IL-6 treated HDAC1-deficient CD4⁺ T cells showed an impaired upregulation of CCR6. Selective inhibition of class I HDACs with the HDAC inhibitor MS-275 under Th17-skewing conditions inhibited the upregulation of chemokine receptor 6 (CCR6) in mouse and human CD4⁺ T cells. Accordingly, analysis of human RNA-sequencing (RNA-seq) data and histological analysis of synovial tissue samples from human RA patients revealed the existence of CD4⁺CCR6⁺ cells with enhanced HDAC1 expression. Our data indicate a key role for HDAC1 for the pathogenesis of CIA and suggest that HDAC1 and other class I HDACs might be promising targets of selective HDAC inhibitors (HDACi) for the treatment of RA.

Hard Tissue Augmentation of Aged Bone by Means of a Tin-Free PLLA-PCL Co-Polymer Exhibiting in vivo Anergy and Long-Term Structural Stability

BACKGROUND

Due to aging, tissue regeneration gradually declines. Contemporary strategies to promote tissue-specific regeneration, in particular in elderly patients, often include synthetic material apt for implantation primarily aiming at upholding body functions and regaining appropriate anatomical and functional integrity.

OBJECTIVE

Biomaterials suitable for complex reconstruction surgical procedures have to exert high physicochemical stability and biocompatibility.

METHOD

A polymer made of poly-L-lactic acid and poly-ε-caprolactone was synthesized by means of a novel tin-free catalytic process. The material was tested in a bioreactor-assisted perfusion culture and implanted in a sheep model for lateral augmentation of the mandible. Histological and volumetric evaluation was performed 3 and 6 months post-implantation.

RESULTS

After synthesis the material could be further refined by cryogrinding and sintering, thus yielding differently porous scaffolds that exhibited a firm and stable appearance. In perfusion culture, no disintegration was observed for extended periods of up to 7 weeks, while mesenchymal stromal cells readily attached to the material, steadily proliferated, and deposited extracellular calcium. The material was tested in vivo together with autologous bone marrow-derived stromal cells. Up to 6 months post-implantation, the material hardly changed in shape with composition also refraining from foreign body reactions.

CONCLUSION

Given the long-term shape stability in vivo, featuring imperceptible degradation and little scarring as well as exerting good compatibility to cells and surrounding tissues, this novel biomaterial is suitable as a space filler in large anatomical defects.

Impact of infrared radiation on UVB-induced skin tumourigenesis in wild type C57BL/6 mice

Additional exposure to infrared radiation leads to a more aggressive phenotype of UVB-induced skin tumours in wild type mice.

Welfare assessment in rabbits raised for meat and laboratory purposes in enclosures with two floor types: Perforated plastic with holes versus slats

Due to welfare concerns and legal restrictions in certain countries, alternatives to wire net floors must be developed in rabbit husbandries. Also, there is a difference in regulations in Europe for laboratory rabbits vs. rabbits bred and kept for meat production. While there are regulations concerning floor design of enclosures for rabbits bred for meat production in many European countries, the European Directive 2010/63 lacks regulations for rabbits used for scientific purposes. This study compares two floors, which meet the Austrian legal requirements for growing rabbits intended for consumption as well as the requirements for laboratory rabbits. The dual use of rabbits bred for meat production and applicable for scientific purposes would avoid the problem of surplus animals of specialized producers for laboratory rabbits. A noryl floor with 12 mm circular holes was compared to a 10 mm slatted plastic floor. Parameters were soiling of cages and animals, parasitic burden, clinical health, and losses using objective scoring. Soiling of cages and animals and coccidial oocytes were significantly higher on the floors with circular holes. Obvious signs of disease showed a non-significant trend to be more frequent in the group with circular holes. This was linked with significantly higher losses. In conclusion, our study clearly shows that the floor with circular hole design cannot be endorsed, although it meets legal requirements. The slatted floor type can be cautiously recommended; however, to assure animal welfare in laboratory rabbits, legal authorities in Europe should take on the responsibility of regulating floor design in this sector.

CCR6 controls autoimmune but not innate immunity-driven experimental arthritis

Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease, characterized by synovial infiltration of various inflammatory cells. Chemokines are involved in controlling the recruitment of different cell types into the synovial membrane. The role of CCR6 in the development of arthritis so far remains unclear. In this study, we investigated the role of CCR6 in the pathogenesis of arthritis using three different murine arthritis models. Compared to WT animals, CCR6^−/− mice developed less clinical signs of arthritis in the collagen‐induced arthritis model but not in the K/BxN serum transfer arthritis model and in the human tumour necrosis factor transgenic arthritis model, suggesting a defect in adaptive effector functions but intact innate effector functions in the development of arthritis in CCR6^−/− animals. In line with this, anti‐collagen antibody levels were significantly reduced in CCR6^−/− mice compared with WT mice. Moreover, we demonstrate enhanced osteoclastogenesis in vitro in CCR6^−/− mice compared with WT mice. However, we did not detect differences in bone mass under steady state conditions in vivo between WT and CCR6‐deficient mice. These data suggest that CCR6 is crucially involved in adaptive but not in innate immunity‐driven arthritis. CCR6 or its chemokine ligand CCL20 might represent a possible new target for the treatment of RA.

In situ fabrication of ultrathin porous alumina and its application for nanopatterning Au nanocrystals on the surface of ion-sensitive field-effect transistors

In situ fabrication in a single step of thin films of alumina exhibiting a thickness of less than 100 nm and nanopores with a highly regular diameter distribution in order to pattern nanostructures over field-effect devices is a critical issue and has not previously been demonstrated. Here we report the fabrication in situ of 50 nm thick ultrathin nanoporous alumina membranes with a regular pore size directly over metal-free gate ion-sensitive field-effect transistors. Depositing thin films of aluminum by an electron beam at a relatively low rate of deposition on top of chips containing the transistors and using a conventional single-step anodization process permits the production of a well-adhering nanoporous ultrathin layer of alumina on the surface of the devices. The anodization process does not substantially affect the electrical properties of the transistors. The small thickness and pore size of ultrathin alumina membranes allow them to be sequentially employed as masks for patterning Au nanocrystals grown by an electroless approach directly on the top of the transistors. The patterning process using a wet chemical approach enables the size of the patterned crystals to be controlled not only by the dimensions of the pores of alumina, but also by the concentration of the reactants employed. Surface modification of these nanocrystals with alkanethiol molecules demonstrates that the electrostatic charge of the functional groups of the molecules can modulate the electrical characteristics of the transistors. These results represent substantial progress towards the development of novel nanostructured arrays on top of field-effect devices that can be applied for chemical sensing or non-volatile memories.

Quantitative transmission electron microscopy analysis of the pressure of helium-filled cracks in implanted silicon

The pressure of crack-shaped cavities formed in silicon upon implantation with helium and subsequent annealing is quantitatively determined from the measurement of diffraction contrast features visible in transmission electron micrographs taken under well-defined dynamical two-beam conditions. For this purpose, simulated images, based on the elastic displacements associated with a Griffith crack, are matched to experimental micrographs, thus yielding unambiguous quantitative data on the ratio p of the cavity pressure to the silicon matrix shear modulus. Experimental results demonstrate cavity radii of some 10 nm and p values up to 0.22, which may be regarded as sufficiently high for the emission of dislocation loops from the cracks.

Spherical aberration correction in tandem with exit-plane wave function reconstruction: interlocking tools for the atomic scale imaging of lattice defects in GaAs

With the availability of resolution boosting and delocalization minimizing techniques, for example, spherical aberration correction and exit-plane wave function reconstruction, high-resolution transmission electron microscopy is drawing to a breakthrough with respect to the atomic-scale imaging of common semiconductor materials. In the present study, we apply a combination of these two state-of-the-art techniques to investigate lattice defects in GaAs-based heterostructures at atomic resolution. Focusing on the direct imaging of stacking faults as well as the core structure of edge and partial dislocations, the practical capabilities of both techniques are illustrated. For the first time, we apply the technique of bright-atom contrast imaging at negative spherical aberration together with an appropriate overfocus setting for the investigation of lattice defects in a semiconductor material. For these purposes, the elastic displacements associated with lattice defects in GaAs viewed along the 110 zone axis are measured from experimental images using reciprocal space strain map algorithms. Moreover, we demonstrate the benefits of the retrieval of the exit-plane wave function not only for the elimination of residual imaging artefacts but also for the proper on-line alignment of specimens during operation of the electron microscope--a basic prerequisite to obtain a fair agreement between simulated images and experimental micrographs.

Direct compositional analysis of AlGaAs/GaAs heterostructures by the reciprocal space segmentation of high-resolution micrographs

A detailed description of a combined reciprocal and real space technique for the mapping of layer compositions across interior interfaces from high-resolution electron micrographs is presented. The analysis is based on the reciprocal space extraction of chemically sensitive image information encoded in lattice images of AlGaAs/GaAs heterostructures taken under optimized imaging conditions. Analysis procedures include centering a set of apertures around chemically sensitive reflections in the Fourier transform of lattice images and performing an inverse transformation, thus extracting composition related information from experimental micrographs. It is demonstrated that this approach is characterized by the same spatial resolution as real space techniques but by improved capabilities with respect to analysing images characterized by a minor signal-to-noise ratio. For illustration purposes the stability of AlAs/GaAs multiple quantum wells grown under low-temperature conditions against thermal treatment as expressed by interfacial roughness parameters is investigated.

High-resolution imaging with an aberration-corrected transmission electron microscope

Recently an electromagnetic hexapole system for the correction of the spherical aberration of the objective lens of a 200 kV transmission electron microscope has been constructed by Haider and coworkers. By appropriately exciting the hexapole elements it is possible to adjust specific values of the spherical aberration coefficient ranging from the value of the original uncorrected instrument over zero even to negative values. In the first part of the paper the consequences of the tunable spherical aberration are investigated. New imaging modes are available: By adjustment of an optimum value for the spherical-aberration coefficient, the point resolution of phase-contrast imaging can be extended to the information limit. Phase-contrast imaging can be improved by a reduced level of contrast delocalisation. For zero aberration contrast delocalisation does not occur. In this case high-resolution investigations are carried out under amplitude-contrast conditions, where the local image intensity of crystalline objects is controlled by electron diffraction channelling. The defocus and spherical aberration values related to the new imaging modes are given. In the second part novel applications of the instrument to semiconductor heterostructures and ceramic grain boundaries are examined.

[Iliopsoas impingement after cementless total hip arthroplasty. Case reports]

Postoperative pain after total hip arthroplasty can be caused by several conditions. We describe two cases of postoperative persistent iliopsoas impingement after cementless implantation of the acetabular component. The groin pain was relieved after revision with a more anteverted acetabular component. We describe the diagnostic methods as well as the principles of the revision.

Resection interposition arthroplasty of the shoulder affected by inflammatory arthritis

To determine the therapeutic value of resection-interposition arthroplasty (RIAP) of shoulders in rheumatoid or other inflammatory arthritis, 53 patients were reviewed clinically and radiographically after a mean follow-up period of 8.2 +/- 4.3 years (3.5 to 17.5 years). The Constant Score averaged 42.33 +/- 16.2 (12 to 76). Patients with a follow-up period of more than 10 years performed significantly worse than those with shorter follow-up periods. In most cases, radiographs showed a progressive medial displacement and loss of size of the humeral head as well as a decrease of the joint space with time. Abduction proved to be highly dependent on the degree of medial displacement of the humeral head, whereas the Constant Scores correlated with the width of the joint space. Despite initially acceptable postoperative results, outcome at longer follow-up periods worsened as the result of wear of the glenoidal cartilage and osseous resorption of the humeral head, resulting in a progressive medialization of the center of rotation.

Recurring synovitis as a possible reason for aseptic loosening of knee endoprostheses in patients with rheumatoid arthritis

We evaluated histologically samples of synovial tissue from the knees of 50 patients with rheumatoid arthritis (RA). The samples were taken during revision for aseptic loosening. The findings were compared with those in 64 knees with osteoarthritis (OA) and aseptic loosening and in 18 knees with RA without loosening. The last group had been revised because of failure of the inlay or the coupling system of a constrained prosthesis. All the patients had had a total ventral synovectomy before implantation of the primary prosthesis. In all three groups a foreign-body reaction and lymphocellular infiltration were seen in more than 80% of the tissue samples. Deposits of fibrin were observed in about one-third to one-half of the knees in all groups. Typical signs of the reactivation of RA such as rheumatoid necrosis and/or proliferation of synovial stromal cells were found in 26% of knees with RA and loosening, but not in those with OA and loosening and in those with RA without loosening. Our findings show that reactivation of rheumatoid synovitis occurs after total knee replacement and may be a cofactor in aseptic loosening in patients with RA.

Quantitative HRTEM analysis of semiconductor quantum dots

Elastic strains and layer compositions of semiconductor quantum dots are quantified by the measurement of lattice fringe spacings from high-resolution micrographs. Analyses of simulated images, taking thin-specimen relaxation into account by application of finite element simulations, demonstrate that the local slopes of these strain profiles may contain severe artefacts mainly caused by local crystal tilts. Nevertheless, average strain values may be measured with sufficient accuracy and can be used to obtain an estimate on average layer compositions by application of the continuum theory of elasticity when analysing experimental micrographs. Focusing on In(x)Ga1-xAs/GaAs and Ge(x)Si1-x/Si heterostructures, it is demonstrated that elastic strains of nanoscale coherent islands are severely decreased due to an elastic relaxation mechanism compared to fully strained two-dimensional layers. The analysis of self-assembled quantum dots and two-dimensional wetting layers buried by capping layers gives clear evidence for a substantial reduction of the lattice strains compared to the values expected for the nominal layer stoichiometries. This observation originates most presumably from a compositional intermixing during epitaxial growth.

[The femoropatellar endoprosthesis--still of value today?]

PURPOSE

Aim of this study was the examination of clinical middle- and long-term results of total femoropatellar endoprostheses type Lubinus (Link, Germany).

METHOD

From 1983 to 1996 12 patients (15 joints) underwent total femoropatellar joint replacement (type Lubinus, Link, Hamburg). All of them have been controlled 7.2 +/- 2.6 years (2 to 12 years) after surgery. The indication was primary osteoarthritis in 6, chondrocalcinosis in 2 and rheumatoid arthritis in 7 cases. In addition to the femoropatellar implants femorotibial endoprostheses have been used in 10 knees: 2 unicondylar medial, 1 unicondylar lateral and 7 bicondylar unicompartimental ones.

RESULTS

According to a modified Hungerford knee rating scale 8 knees resulted excellent, 2 fair and 4 poor. One knee was excluded after revision surgery due to a loosened tibial component of a medial unicompartimental knee arthroplasty. The 4 poor outcomes resulted from femoropatellar replacements in chondrocalcinosis (2 cases), rheumatoid arthritis and osteoarthritis, (one case each), affecting the femorotibial joint as well.

CONCLUSIONS

In those cases of simultaneous femorotibial joint affection--even if this is merely slight and beginning and if the femoropatellar complaints are actually clearly dominating--the sole femoropatellar surface replacement seems to be contraindicated according to our experiences. Providing correct and strict indications this endoprosthesis can be recommended for sole femoropatellar osteoarthritis especially since loosening of endoprosthetic components was not been found in this study.

Surgery of the rheumatoid forefoot with special reference to the plantar approach

The key to the understanding of rheumatoid forefoot deformities is the predominant joint involvement of the tibial side of the hindfoot, of the fibular tarsometatarsal joints, and the destruction especially of the metatarsal heads. Independent of these patterns, the predominant sources of pain and impaired function, and thus of surgical remedies, remains the metatarsophalangeal joints. The authors prefer forefoot arthroplasty consisting of a judicious resection of the metatarsal heads, plantar capsulorraphy, tenolysis and rerouting of the tendons, through a dorsomedial approach to the great toe basal joint, and through a transverse plantar approach with dermodesis (plastic resection of a plantar wedge of skin and subcutaneous tissue) for the lesser toes. This method yields excellent pain relief that does not deteriorate for at least 15 years. However, 1/2 of the nearly complete postoperative correction was lost again within 10 years, and barefoot walking again became more difficult. Reviewing the literature, one cannot detect a clearcut superiority of plantar versus dorsal approaches, nor of one surgical routine versus another.

Resection arthroplasty of the metacarpophalangeal joints in rheumatoid arthritis. Results after more than 15 years

In a retrospective study of resection arthroplasty of the MP joints in rheumatoid arthritis, 23 patients (32 hands, 128 joints) have been followed for 15 to 22 years. Patient satisfaction was high, and all patients had significant pain relief. Active motion of the joints averaged 35 degrees, ranging from full extension to 35 degrees of flexion. Ankyloses developed in five hands (13 joints, 10%). Ulnar deviation of more than 15 degrees occurred in six patients (ten hands, 30%). Over the course of several years a significant remodelling of the joints was to be observed. In six hands (19%) the metacarpal heads became spontaneously restored to ball-shaped geometry. Gross metacarpal resorption was observed in nine hands (30%), causing significant shortening of the metacarpals. In one-third of patients the final result was rated as good, fair and poor, respectively. Careful patient selection is mandatory. Patients with mutilating arthritis should be excluded from the procedure; rheumatoid destruction of the wrist joint definitely influences the final result.

CT and MRI evaluation of tenosynovitis of the rheumatoid hindfoot

Thirty-nine patients with rheumatoid arthritis who had presented with tarsitis before, were investigated at the level of the rearfoot. The first 17 patients had CT with previous tenography when it was possible; the following 22 patients had MRI with gadolinium injection. Tendon involvement appeared in 52.9% of the cases on CT, and in 90% of the feet on MRI; therefore, in case of clinical or radiological signs of tarsitis, it appears that tendon involvement must be suspected. With the two procedures the tibialis posterior tendon lesions were very predominant. In the majority of the patients (31/39), there was associated involvement of two or more tendons. If there is a ruptured tendon, the authors think that one must be cautious with surgical tendinous transfer; indeed, the long-term results of this surgical procedure present a strong probability of being compromised in rheumatoid arthritis which is a progressive disease.

[Synovectomy in treatment of inflammatory rheumatic diseases: historical or current?]

Synovectomy as the oldest "classical" method of arthritis surgery became a subject of controversial discussion during the past decade, especially due to controlled prospective studies published in the English-speaking literature. By analysis of the validity of these studies and respecting the European experience and literature, the arguments for a well timed radical and meticulous synovectomy as an effective and proven local prevention of progressive joint destructions are presented.

Recent advances in the surgical treatment of rheumatoid arthritis

Arthritis surgery in the Federal Republic of Germany is an established subspecialty of orthopedic surgery. The scientific organization Arbeitgemeinschaft für Rheumaorthopädie (Association for Rheumatic Orthopedics) is an official section of the Deutsche Gesellschaft für Orthopedics and Traumatology) and has very close connections with the European Rheumatoid Arthritis Surgical Society. There are many common activities within this group, especially regarding uniform documentation, which began with the elbow. Furthermore, there are standardized procedures in operative synovectomy, including new trends, e.g., arthroscopic synovectomy. Another special interest is focused on alternatives to endoprosthetic replacement, in particular on resection interposition arthroplasty. With regard to endoprosthetic replacement, the question of cementing or not is controversial; however, there are strong arguments for cementless fixation, especially for hip endoprostheses. Arthritis surgery in Germany reflects modern trends all over the world where rheumatology is a subspecialty bridging the gap between internal medicine and orthopedics.

[Changes in sex behavior caused by fear of AIDS--an empirical study of male heterosexual and homosexual students]

This study examines changes in sexual behaviour in the context of the fear of being infected with the HI-Virus and, in particular, considers the influence of a relationship and of sexual orientation. The population studied included 72 homosexual and 54 heterosexual male students.

RESULTS

(1) Only 7% of the heterosexuals, but 68% of the homosexuals report changes in their sexual behaviour pattern. (2) Among the homosexual group practice-oriented alterations (avoiding oral and anal sex or using condoms for these practices) and relationship-oriented alterations (reducing the number of sex partners) occur likewise. (3) Practice-oriented changes are less frequent among homosexuals with partners than those without. (4) Those homosexuals questioned who are in conflict with their homosexuality have less confidence in potential sex partners. They are more inclined to have "monogamous" relationships.

[Long-term results of finger joint endoprostheses of the "St. Georg" model]

Long-term results of 100 cemented finger joint replacements (endoprosthesis) of the "St. Georg" design are presented. Good reduction in pain and swelling was noted. There was only a little improvement in motion of the replaced metacarpophalangeal joint, but more in the proximal interphalangeal joint; the latter decreasing from radial to ulnar. Approximately one half of the preoperative ulnar deviation was corrected. Mechanical failures occurred in approximately 30% of the implants. Without changing the design, this demanding technique cannot be recommended routinely.

Concentration of azapropazone in synovial tissues and fluid

The concentration-time curves of azapropazone in synovial fluid and tissues have been studied in arthritic patients after an i.v. bolus (600 mg) and under steady-state conditions. Synovial fluid and tissue samples were taken intraoperatively 0.45-60 h after administration. The azapropazone concentrations in synovial fluid, synovial tissue and plasma were correlated. The levels in synovial fluid were usually lower than corresponding plasma levels. Under steady-state conditions azapropazone did not accumulate in synovial tissues.