Assessing the role of surface layer and molecular probe size in diffusion within meniscus tissue

Diffusion within extracellular matrix is essential to deliver nutrients and larger metabolites to the avascular region of the meniscus. It is well known that both structure and composition of the meniscus vary across its regions; therefore, it is crucial to fully understand how the heterogenous meniscal architecture affects its diffusive properties. The objective of this study was to investigate the effect of meniscal region (core tissue, femoral, and tibial surface layers) and molecular weight on the diffusivity of several molecules in porcine meniscus. Tissue samples were harvested from the central area of porcine lateral menisci. Diffusivity of fluorescein (MW 332 Da) and three fluorescence-labeled dextrans (MW 3k, 40k, and 150k Da) was measured via fluorescence recovery after photobleaching. Diffusivity was affected by molecular size, decreasing as the Stokes' radius of the solute increased. There was no significant effect of meniscal region on diffusivity for fluorescein, 3k and 40k dextrans (p>0.05). However, region did significantly affect the diffusivity of 150k Dextran, with that in the tibial surface layer being larger than in the core region (p = 0.001). Our findings contribute novel knowledge concerning the transport properties of the meniscus fibrocartilage. This data can be used to advance the understanding of tissue pathophysiology and explore effective approaches for tissue restoration.

Heterogeneity of dynamic shear properties of the meniscus: A comparison between tissue core and surface layers

Damage to the meniscus has been associated with excessive shear loads. Aimed at elucidating meniscus pathophysiology, previous studies have investigated the shear properties of the meniscus fibrocartilaginous core. However, the meniscus is structurally inhomogeneous, with an external cartilaginous envelope (tibial and femoral surface layers) wrapping the tissue core. To date, little is known about the shear behavior of the surface layers. The objective of this study was to measure the dynamic shear properties of the surface layers and derive empirical relations with their composition. Specimens were harvested from tibial and femoral surface layers and core of porcine menisci (medial and lateral, n = 10 each). Frequency sweep tests yielded complex shear modulus (G*) and phase shifts (δ). Mechanical behavior of regions was described by a generalized Maxwell model. Correlations between shear moduli with water and glycosaminoglycans content of the tissue regions were investigated. The femoral surface had the lowest shear modulus, when compared to core and tibial regions. A 3-relaxation times Maxwell model satisfactorily interpreted the shear behavior of all tissue regions. Inhomogeneous tissue composition was also observed, with water content in the surface layers being higher when compared with tissue core. Water content negatively correlated with shear properties in all regions. The lower measured shear properties in the femoral layer may explain the higher prevalence of meniscal tears on the superior surface of the tissue. The heterogenous behavior of the tissue in shear provides insight into meniscus pathology and has important implications for efforts to tissue engineer replacement tissues.

Effect of molecular weight and tissue layer on solute partitioning in the knee meniscus

Objective

Knee meniscus tissue is partly vascularized, meaning that nutrients must be transported through the extracellular matrix of the avascular portion to reach resident cells. Similarly, drugs used as therapeutic agents to treat meniscal pathologies rely on transport through the tissue. The driving force of diffusive transport is the gradient of concentration, which depends on molecular solubility. The meniscus is organized into a core region sandwiched between the tibial and femoral superficial layers. Structural differences exist across meniscal regions; therefore, regional differences in solubility are also hypothesized.

Methods

Samples from the core, tibial and femoral layers were obtained from 5 medial and 5 lateral porcine menisci. The partition coefficient (K) of fluorescein, 3 ​kDa and 40 ​kDa dextrans in the layers of the meniscus was measured using an equilibration experiment. The effect of meniscal compartment, layer, and solute molecular weight on K was analyzed using a three-way ANOVA.

Results

K ranged from a high of ∼2.9 in fluorescein to a low of ∼0.1 in 40 ​kDa dextran and was inversely related to the solute molecular weight across all tissue regions. Tissue layer only had a significant effect on partitioning of 40k Dex solute, which was lower in the tibial surface layer relative to the core (p ​= ​0.032).

Conclusion

This study provides insight into depth-dependent partitioning in the meniscus, indicating the limiting effect of the meniscus superficial layer on solubility increases with solute molecular size. This illustrates how the surface layers could potentially reduce the effectiveness of drug delivery therapies incorporating large molecules (>40 ​kDa).

Tensile energy dissipation and mechanical properties of the knee meniscus: relationship with fiber orientation, tissue layer, and water content

Introduction: The knee meniscus distributes and dampens mechanical loads. It is composed of water (∼70%) and a porous fibrous matrix (∼30%) with a central core that is reinforced by circumferential collagen fibers enclosed by mesh-like superficial tibial and femoral layers. Daily loading activities produce mechanical tensile loads which are transferred through and dissipated by the meniscus. Therefore, the objective of this study was to measure how tensile mechanical properties and extent of energy dissipation vary by tension direction, meniscal layer, and water content. Methods: The central regions of porcine meniscal pairs (n = 8) were cut into tensile samples (4.7 mm length, 2.1 mm width, and 0.356 mm thickness) from core, femoral and tibial components. Core samples were prepared parallel (circumferential) and perpendicular (radial) to the fibers. Tensile testing consisted of frequency sweeps (0.01-1Hz) followed by quasi-static loading to failure. Dynamic testing yielded energy dissipation (ED), complex modulus (E*), and phase shift (δ) while quasi-static tests yielded Young's Modulus (E), ultimate tensile strength (UTS), and strain at UTS (ε_UTS). To investigate how ED is influenced by the specific mechanical parameters, linear regressions were performed. Correlations between sample water content (φ_w) and mechanical properties were investigated. A total of 64 samples were evaluated. Results: Dynamic tests showed that increasing loading frequency significantly reduced ED (p < 0.05). Circumferential samples had higher ED, E*, E, and UTS than radial ones (p < 0.001). Stiffness was highly correlated with ED (R² > 0.75, p < 0.01). No differences were found between superficial and circumferential core layers. ED, E*, E, and UTS trended negatively with φ_w (p < 0.05). Discussion: Energy dissipation, stiffness, and strength are highly dependent on loading direction. A significant amount of energy dissipation may be associated with time-dependent reorganization of matrix fibers. This is the first study to analyze the tensile dynamic properties and energy dissipation of the meniscus surface layers. Results provide new insights on the mechanics and function of meniscal tissue.

Assessment of meat quality attributes of four commercial broiler strains processed at various market weights

As the demand for poultry meat continues to rise, industry production is constantly challenged with obtaining consumer needs. Integrators have answered this increasing demand by improving the growth rate of broilers allowing for increased production efficiently. The resulting broiler produces higher yields and a larger quantity of fresh poultry to satisfy consumer needs. However, this increase in efficiency has cost integrators as new quality issues continue to manifest through global production. Therefore, the objective of the current experiment was to evaluate the effect of genetic strain (standard and high yielding) and target weight on meat quality attributes such as pH, water holding capacity (WHC), and tenderness, alongside meat quality defects such as breast and tender myopathies. In the current study, 1,800 broilers from 4 commercial strains (2 high breast yielding (HY) and 2 standard yielding (SY) were raised sex separate to evaluate meat quality trends over time at 6 previously defined market weights. Birds were processed at weights ranging from 2,043 to 4,313 g in 454 g increments. HY strains produced higher breast and tender yields than those of SY strains (P < 0.05). There was an increase in breast and tender yield as target weight increased (P < 0.05) for both HY and SY strains. Differences were observed between strains for all fillet dimensions (P < 0.05); however, these measurements increased as target weight increased as expected. Woody breast (WB) had a higher severity (P < 0.05) in HY strains over SY strains, for both males and females. Differences were observed in white striping (WS; P < 0.05) for females in both strains, but no differences were observed in males. A main effect of target was noticed for both WB and WS (P < 0.05), expressing increased severity as target weight increased. Shear values were influenced more by target weight (P < 0.05), but inconsistent differences were observed between HY and SY groups. Meullenet-Owens Razor Shear (MORS) energy values increased slightly as target weights increased (P < 0.05) from 2,951 to 4,313 g in both males and females, but differences were minor and inconsistent with the smaller carcass weights. The MORS peak counts generally increased as target weight increased for both sexes. While strain had minimal effects on meat quality attributes, processing weight had a greater influence on quality, specifically muscle myopathies, WHC, and shear properties.

Biomechanical properties of porcine meniscus as determined via AFM: Effect of region, compartment and anisotropy

The meniscus is a fibrocartilaginous tissue that plays an essential role in load transmission, lubrication, and stabilization of the knee. Loss of meniscus function, through degeneration or trauma, can lead to osteoarthritis in the underlying articular cartilage. To perform its crucial function, the meniscus extracellular matrix has a particular organization, including collagen fiber bundles running circumferentially, allowing the tissue to withstand tensile hoop stresses developed during axial loading. Given its critical role in preserving the health of the knee, better understanding structure-function relations of the biomechanical properties of the meniscus is critical. The main objective of this study was to measure the compressive modulus of porcine meniscus using Atomic Force Microscopy (AFM); the effects of three key factors were investigated: direction (axial, circumferential), compartment (medial, lateral) and region (inner, outer). Porcine menisci were prepared in 8 groups (= 2 directions x 2 compartments x 2 regions) with n = 9 per group. A custom AFM was used to obtain force-indentation curves, which were then curve-fit with the Hertz model to determine the tissue's compressive modulus. The compressive modulus ranged from 0.75 to 4.00 MPa across the 8 groups, with an averaged value of 2.04±0.86MPa. Only direction had a significant effect on meniscus compressive modulus (circumferential > axial, p = 0.024), in agreement with earlier studies demonstrating that mechanical properties in the tissue are anisotropic. This behavior is likely the result of the particular collagen fiber arrangement in the tissue and plays a key role in load transmission capability. This study provides important information on the micromechanical properties of the meniscus, which is crucial for understanding tissue pathophysiology, as well as for developing novel treatments for tissue repair.

Characterization of growth patterns and carcass characteristics of male and female broilers from four commercial strains fed high or low density diets

Over the last few decades, the poultry industry has seen the emergence of various market segments that are beneficial for rearing various flock sizes. Two concurrent experiments consisting of 1,200 broilers each were conducted to evaluate the effects of broiler size and diet on the performance of four commercially available broiler strains, including 2 standard yielding (SY) and 2 high yielding (HY) strains. Within each experiment (Experiment 1: males, Experiment 2: females), a small bird (38 and 40 d processing) and big bird (47 and 54 d processing) debone market were targeted to give variable carcass size. Two polyphasic diets were fed based on varying of amino acid densities. The low-density diet (L) consisted of 1.20, 1.10, 1.00, and 0.96% digestible Lys and the high-density diet (H) consisted of 1.32, 1.21, 1.10, and 1.06% across the 4-phases, respectively, with similar essential amino acid to digestible Lys ratios between the L and H diets in each phase. Weekly BW, BW gain, feed intake, and feed conversion ratio were assessed, as well as processing yields during both experiments. Broilers fed the H diets responded better than those fed the L diets, regardless of sex, with increased BW and decreased FCR (P < 0.05). Male HY strains provided the highest carcass yields (P < 0.05) compared to SY strains, with no differences observed in females (P > 0.05). High density diets (Diet H) also produced increases in carcass, breast, and tender yield (P < 0.05) for males, but that trend was not present in carcass yield for females (P < 0.05). Overall, strain impacted performance traits and carcass yields. Therefore, the use of specific strains and amino acid density for various market segments is beneficial for integrators to maximize return.

Strain-Dependent Diffusivity of Small and Large Molecules in Meniscus

Due to lack of full vascularization, the meniscus relies on diffusion through the extracellular matrix to deliver small (e.g., nutrients) and large (e.g., proteins) to resident cells. Under normal physiological conditions, the meniscus undergoes up to 20% compressive strains. While previous studies characterized solute diffusivity in the uncompressed meniscus, to date, little is known about the diffusive transport under physiological strain levels. This information is crucial to fully understand the pathophysiology of the meniscus. The objective of this study was to investigate strain-dependent diffusive properties of the meniscus fibrocartilage. Tissue samples were harvested from the central portion of porcine medial menisci and tested via fluorescence recovery after photobleaching to measure diffusivity of fluorescein (332 Da) and 40 K Da dextran (D40K) under 0%, 10%, and 20% compressive strain. Specifically, average diffusion coefficient and anisotropic ratio, defined as the ratio of the diffusion coefficient in the direction of the tissue collagen fibers to that orthogonal, were determined. For all the experimental conditions investigated, fluorescein diffusivity was statistically faster than that of D40K. Also, for both molecules, diffusion coefficients significantly decreased, up to ∼45%, as the strain increased. In contrast, the anisotropic ratios of both molecules were similar and not affected by the strain applied to the tissue. This suggests that compressive strains used in this study did not alter the diffusive pathways in the meniscus. Our findings provide new knowledge on the transport properties of the meniscus fibrocartilage that can be leveraged to further understand tissue pathophysiology and approaches to tissue restoration.

Mechanisms of energy dissipation and relationship with tissue composition in human meniscus

OBJECTIVE

The human meniscus is essential in maintaining proper knee joint function. The meniscus absorbs shock, distributes loads, and stabilizes the knee joint to prevent the onset of osteoarthritis. The extent of its shock-absorbing role can be estimated by measuring the energy dissipated by the meniscus during cyclic mechanical loading.

METHODS

Samples were prepared from the central and horn regions of medial and lateral human menisci from 8 donors (both knees for total of 16 samples). Cyclic compression tests at several compression strains and frequencies yielded the energy dissipated per tissue volume. A GEE regression model was used to investigate the effects of compression, meniscal side and region, and water content on energy dissipation in order to account for repeated measures within samples.

RESULTS

Energy dissipation by the meniscus increased with compressive strain from ∼0.1 kJ/m³ (at 10% strain) to ∼10 kJ/m³ (at 20% strain) and decreased with loading frequency. Samples from the anterior region provided the largest energy dissipation when compared to central and posterior samples (P < 0.05). Water content for the 16 meniscal tissues was 77.9 (C.I. 72.0-83.8%) of the total tissue mass. A negative correlation was found between energy dissipation and water content (P < 0.05).

CONCLUSION

The extent of energy dissipated by the meniscus is inversely related to loading frequency and meniscal water content.

Mechanical properties of meniscal circumferential fibers using an inverse finite element analysis approach

The extracellular matrix (ECM) of the meniscus is a gel-like water solution of proteoglycans embedding bundles of collagen fibers mainly oriented circumferentially. Collagen fibers significantly contribute to meniscal mechanics, however little is known about their mechanical properties. The objective of this study was to propose a constitutive model for collagen fibers embedded in the ECM of the meniscus and to characterize the tissue's pertinent mechanical properties. It was hypothesized that a linear fiber reinforced viscoelastic constitutive model is suitable to describe meniscal mechanical behavior in shear. It was further hypothesized that the mechanical properties governing the model depend on the tissue's composition. Frequency sweep tests were conducted on eight porcine meniscal specimens. A first cohort of experimental data resulted from tissue specimens where collagen fibers oriented parallel with respect to the shear plane were used. This was done to eliminate the contribution of collagen fibers from the mechanical response and characterize the mechanical properties of the ECM. A second cohort with fibers orthogonally oriented with respect to the shear plane that were used to determine the elastic properties of the collagen fibers via inverse finite element analysis. Our testing protocol revealed that tissue ECM mechanical behavior could be described by a generalized Maxwell model with 3 relaxation times. The inverse finite element analysis suggested that collagen fibers can be modeled as linear elastic elements having an average elastic modulus of 287.5 ± 62.6 MPa. Magnitudes of the mechanical parameters governing the ECM and fibers were negatively related to tissue water content.

Computational Modeling Intervertebral Disc Pathophysiology: A Review

Lower back pain is a medical condition of epidemic proportion, and the degeneration of the intervertebral disc has been identified as a major contributor. The etiology of intervertebral disc (IVD) degeneration is multifactorial, depending on age, cell-mediated molecular degradation processes and genetics, which is accelerated by traumatic or gradual mechanical factors. The complexity of such intertwined biochemical and mechanical processes leading to degeneration makes it difficult to quantitatively identify cause–effect relationships through experiments. Computational modeling of the IVD is a powerful investigative tool since it offers the opportunity to vary, observe and isolate the effects of a wide range of phenomena involved in the degenerative process of discs. This review aims at discussing the main findings of finite element models of IVD pathophysiology with a special focus on the different factors contributing to physical changes typical of degenerative phenomena. Models presented are subdivided into those addressing role of nutritional supply, progressive biochemical alterations stemming from an imbalance between anabolic and catabolic processes, aging and those considering mechanical factors as the primary source that induces morphological change within the disc. Limitations of the current models, as well as opportunities for future computational modeling work are also discussed.

EFFECTS OF SOLUTE SIZE AND TISSUE COMPOSITION ON MOLECULAR AND MACROMOLECULAR DIFFUSIVITY IN HUMAN KNEE CARTILAGE

Objective

Articular cartilage is an avascular tissue. Accordingly, diffusivity represents a fundamental transport mechanism for nutrients and other molecular signals regulating its cell metabolism and maintenance of the extracellular matrix. Understanding how solutes spread into articular cartilage is crucial to elucidating its pathologies, and to designing treatments for repair and restoration of its extracellular matrix. As in other connective tissues, diffusivity in articular cartilage may vary depending both its composition and the specific diffusing solute. Hence, this study investigated the roles of solute size and tissue composition on molecular diffusion in knee articular cartilage.

Design

FRAP tests were conducted to measure diffusivity of five molecular probes, with size ranging from ~332Da to 70,000Da, in human knee articular cartilage. The measured diffusion coefficients were related to molecular size, as well as water and glycosaminoglycan (GAG) content of femoral and tibial condyle cartilage.

Results

Diffusivity was affected by molecular size, with the magnitude of the diffusion coefficients decreasing as the Stokes radius of the probe increased. The values of diffusion coefficients in tibial and femoral samples were not significantly different from one another, despite the fact that tibial samples exhibited significantly higher water content and lower GAG content of the femoral specimens. Water content did not affect diffusivity. In contrast, diffusivities of large molecules were sensitive to GAG content.

Conclusions

This study provides new knowledge on the mechanisms of diffusion in articular cartilage. Our findings can be leveraged to further investigate osteoarthritis and to design treatments for cartilage restoration or replacement.

Viscoelastic and equilibrium shear properties of human meniscus: Relationships with tissue structure and composition

The meniscus is crucial in maintaining the knee function and protecting the joint from secondary pathologies, including osteoarthritis. Although most of the mechanical properties of human menisci have been characterized, to our knowledge, its dynamic shear properties have never been reported. Moreover, little is known about meniscal shear properties in relation to tissue structure and composition. This is crucial to understand mechanisms of meniscal injury, as well as, in regenerative medicine, for the design and development of tissue engineered scaffolds mimicking the native tissue. Hence, the objective of this study was to characterize the dynamic and equilibrium shear properties of human meniscus in relation to its anisotropy and composition. Specimens were prepared from the axial and the circumferential anatomical planes of medial and lateral menisci. Frequency sweeps and stress relaxation tests yielded storage (G') and loss moduli (G″), and equilibrium shear modulus (G). Correlations of moduli with water, glycosaminoglycans (GAGs), and collagen content were investigated. The meniscus exhibited viscoelastic behavior. Dynamic shear properties were related to tissue composition: negative correlations were found between G', G″ and G, and meniscal water content; positive correlations were found for G' and G″ with GAG and collagen (only in circumferential samples). Circumferential samples, with collagen fibers orthogonal to the shear plane, exhibited superior dynamic mechanical properties, with G' ~70 kPa and G″ ~10 kPa, compared to those of the axial plane ~15 kPa and ~1 kPa, respectively. Fiber orientation did not affect the values of G, which ranged from ~50 to ~100 kPa.

Compressive Properties and Hydraulic Permeability of Human Meniscus: Relationships With Tissue Structure and Composition

The meniscus is crucial in maintaining knee function and protecting the joint from secondary pathologies, including osteoarthritis. The meniscus has been shown to absorb up to 75% of the total load on the knee joint. Mechanical behavior of meniscal tissue in compression can be predicted by quantifying the mechanical parameters including; aggregate modulus (H) and Poisson modulus (ν), and the fluid transport parameter: hydraulic permeability (K). These parameters are crucial to develop a computational model of the tissue and for the design and development of tissue engineered scaffolds mimicking the native tissue. Hence, the objective of this study was to characterize the mechanical and fluid transport properties of human meniscus and relate them to the tissue composition. Specimens were prepared from the axial and the circumferential anatomical planes of the tissue. Stress relaxation tests yielded the H, while finite element modeling was used to curve fit for ν and K. Correlations of moduli with water and glycosaminoglycans (GAGs) content were investigated. On average H was found to be 0.11 ± 0.078 MPa, ν was 0.32 ± 0.057, and K was 2.9 ± 2.27 × 10^-15 m⁴N^-1s^-1. The parameters H, ν, and K were not found to be statistically different across compression orientation or compression level. Water content of the tissue was 77 ± 3.3% while GAG content was 8.79 ± 1.1%. Interestingly, a weak negative correlation was found between H and water content (R² ~ 34%) and a positive correlation between K and GAG content (R² ~ 53%). In conclusion, while no significant differences in transport and compressive properties can be found across sample orientation and compression levels, data trends suggest potential relationships between magnitudes of H and K, and GAG content.

Molecular and macromolecular diffusion in human meniscus: relationships with tissue structure and composition

OBJECTIVE

To date, the pathophysiology of the meniscus has not been fully elucidated. Due to the tissue's limited vascularization, nutrients and other molecular signals spread through the extracellular matrix via diffusion or convection (interstitial fluid flow). Understanding transport mechanisms is crucial to elucidating meniscal pathophysiology, and to designing treatments for repair and restoration of the tissue. Similar to other fibrocartilaginous structures, meniscal morphology and composition may affect its diffusive properties. The objective of this study was to investigate the role of solute size, and tissue structure and composition on molecular diffusion in meniscus tissue.

DESIGN

Using a custom FRAP technique developed in our lab, we measured the direction-dependent diffusivity in human meniscus of six different molecular probes of size ranging from ∼300Da to 150,000Da. Diffusivity measurements were related to sample water content. SEM images were used to investigate collagen structure in relation to transport mechanisms.

RESULTS

Diffusivity was anisotropic, being significantly faster in the direction parallel to collagen fibers when compared the orthogonal direction. This was likely due to the unique structural organization of the tissue presenting pores aligned with the fibers, as observed in SEM images. Diffusion coefficients decreased as the molecular size increased, following the Ogston model. No significant correlations were found among diffusion coefficients and water content of the tissue.

CONCLUSIONS

This study provides new knowledge on the mechanisms of molecular transport in meniscal tissue. The reported results can be leveraged to further investigate tissue pathophysiology and to design treatments for tissue restoration or replacement.

Effects of Oxygen Concentration and Culture Time on Porcine Nucleus Pulposus Cell Metabolism: An in vitro Study

Low back pain is a common ailment that affects millions of individuals each year and is linked to degeneration of the intervertebral discs in the spine. Intervertebral disc degeneration is known to result from an imbalance in anabolic and catabolic activity by disc cells. Due to the avascular nature of the intervertebral disc, oxygen deficiency may occur in the central nucleus pulposus (NP). The resulting hypoxia affects matrix regulation and energy metabolism of disc cells, although the mechanisms are not fully understood. This study investigates in vitro glucose consumption and gene expression by NP cells over time under varying oxygen tensions. Notochordal porcine NP cells were cultured in agarose discs at 21, 5, or 1% oxygen tension for 1, 5, or 10 days. The expression of 10 key matrix genes, as well as Brachyury (T), by NP cells was analyzed using RT-PCR. Glucose consumption was measured using a two-point method. Results show that culture time and oxygen tension significantly affect glucose consumption rates by porcine NP cells. There were also significant changes in T expression based on oxygen level and culture time. The 1% oxygen tension had a significantly higher T expression on day 10 than the other two groups, which may indicate a better maintenance of the notochordal phenotype. MMP 1 and 13 expression increased over time for all groups, while only the 5% group showed an increase over time for MMP 3. TIMP expression followed the direction of MMPs but to a lesser magnitude. Five percent and twenty-one percent oxygen tensions led to decreases in anabolic gene expression while 1% led to increases. Oxygen concentration and culture time significantly impacted glucose consumption rate and the gene expression of matrix regulatory genes with hypoxic conditions most accurately maintaining the proper NP phenotype. This information is valuable not only for understanding disc pathophysiology, but also for harnessing the potential of notochordal NP cells in therapeutic applications.

Diffusion of antibiotics in intervertebral disc

Delivering charged antibiotics to the intervertebral disc is challenging because of the avascular, negatively charged extracellular matrix (ECM) of the tissue. The purpose of this study was to measure the apparent diffusion coefficient of two clinically relevant, charged antibiotics, vancomycin (positively charged) and oxacillin (negatively charged) in IVD. A one-dimensional steady state diffusion experiment was employed to measure the apparent diffusion coefficient of the two antibiotics in bovine coccygeal annulus fibrosus (AF) tissue. The averaged apparent diffusion coefficient for vancomycin under 20% compressive strain was 7.94 ± 2.00 × 10^-12 m²/s (n = 10), while that of oxacillin was 2.26 ± 0.68 × 10^-10 m²/s (n = 10). A student's t-test showed that the diffusivity of vancomycin was significantly lower than that of oxacillin. This finding may be attributed to two factors: solute size and possible binding effects. Vancomycin is approximately 3 times larger in molecular weight than oxacillin, meaning that steric hindrance likely plays a role in the slower transport. Reversible binding between positive vancomycin and the negative ECM could also slow down the rate of diffusion. Therefore, more investigation is necessary to determine the specific relationship between net charge on antibiotic and diffusion coefficients in IVD. This study provides essential quantitative information regarding the transport rates of antibiotics in the IVD, which is critical in using computational modeling to design effective strategies to treat disc infection.

Hydraulic permeability of meniscus fibrocartilage measured via direct permeation: Effects of tissue anisotropy, water volume content, and compressive strain

Hydraulic permeability is an important material property of cartilaginous tissues, governing the rate of fluid flow, which is crucial to tissue biomechanics and cellular nutrition. The effects of strain, anisotropy, and region on the hydraulic permeability in meniscus tissue have not been fully elucidated. Using a one-dimensional direct permeation test, we measured the hydraulic permeability within statically compressed porcine meniscus specimens, prepared such that the explants were in either the axial or circumferential direction of either the central or horn (axial direction only) region of the medial and lateral menisci. A constant flow was applied and the pressure difference was measured using pressure transducers. Specimens were tested under 10-20% compressive strain. Permeability values were in the range of 1.53-1.87 × 10^-15 m⁴/Ns, which is comparable to values found in the literature. Permeability was significantly anisotropic, being higher in the circumferential direction than in the axial direction. Additionally, there was a significant negative correlation between strain level and permeability for all groups. Lastly, no statistically significant difference was found between permeability coefficients from different regional locations. This study provides important information regarding structure-function relationships in meniscal tissues that helps to elucidate biomechanics and transport in the tissue, and can aid in the understanding of the tissue's role in the function of the knee joint and onset of osteoarthritis.

The nutrition of the human meniscus: A computational analysis investigating the effect of vascular recession on tissue homeostasis

The meniscus is essential to the functioning of the knee, offering load support, congruency, lubrication, and protection to the underlying cartilage. Meniscus degeneration affects ∼35% of the population, and potentially leads to knee osteoarthritis. The etiology of meniscal degeneration remains to be elucidated, although many factors have been considered. However, the role of nutritional supply to meniscus cells in the pathogenesis of meniscus degeneration has been so far overlooked. Nutrients are delivered to meniscal cells through the surrounding synovial fluid and the blood vessels present in the outer region of the meniscus. During maturation, vascularization progressively recedes up to the outer 10% of the tissue, leaving the majority avascular. It has been hypothesized that vascular recession might significantly reduce the nutrient supply to cells, thus contributing to meniscus degeneration. The objective of this study was to evaluate the effect of vascular recession on nutrient levels available to meniscus cells. This was done by developing a novel computational model for meniscus homeostasis based on mixture theory. It was found that transvascular transport of nutrients in the vascularized region of the meniscus contributes to more than 40% of the glucose content in the core of the tissue. However, vascular recession does not significantly alter nutrient levels in the meniscus, reducing at most 5% of the nutrient content in the central portion of the tissue. Therefore, our analysis suggests that reduced vascularity is not likely a primary initiating source in tissue degeneration. However, it does feasibly play a key role in inability for self-repair, as seen clinically.

Cough in exercise and athletes

Cough is the most common respiratory symptom reported by athletes and can significantly impact on health status, ability to train and athletic performance. The presence of cough in an athlete is typically taken to indicate exercise-induced bronchoconstriction (EIB), yet in many athletes with chronic cough there is no objective evidence of airway hyper-responsiveness (AHR) or heightened airway inflammation. Moreover, cough in athletes often fails to respond to a therapeutic asthma strategy, thus further work is urgently needed to progress our understanding of the pathophysiology of exercise-associated cough in this unique population. This article provides an overview of the current state of knowledge of exercise-associated cough in athletes. The article summarises our understanding of pathophysiological basis of cough in this context and provides a pragmatic clinical approach to this problem.

Effect of Strain, Region, and Tissue Composition on Glucose Partitioning in Meniscus Fibrocartilage

A nearly avascular tissue, the knee meniscus relies on diffusive transport for nutritional supply to cells. Nutrient transport depends on solute partitioning in the tissue, which governs the amount of nutrients that can enter a tissue. The purpose of the present study was to investigate the effects of mechanical strain, tissue region, and tissue composition on the partition coefficient of glucose in meniscus fibrocartilage. A simple partitioning experiment was employed to measure glucose partitioning in porcine meniscus tissues from two regions (horn and central), from both meniscal components (medial and lateral), and at three levels of compression (0%, 10%, and 20%). Partition coefficient values were correlated to strain level, water volume fraction, and glycosaminoglycan (GAG) content of tissue specimens. Partition coefficient values ranged from 0.47 to 0.91 (n = 48). Results show that glucose partition coefficient is significantly (p < 0.001) affected by compression, decreasing with increasing strain. Furthermore, we did not find a statistically significant effect of tissue when comparing medial versus lateral (p = 0.181) or when comparing central and horn regions (p = 0.837). There were significant positive correlations between tissue water volume fraction and glucose partitioning for all groups. However, the correlation between GAG content and partitioning was only significant in the lateral horn group. Determining how glucose partitioning is affected by tissue composition and loading is necessary for understanding nutrient availability and related tissue health and/or degeneration. Therefore, this study is important for better understanding the transport and nutrition-related mechanisms of meniscal degeneration.

Effect of Static Compressive Strain, Anisotropy, and Tissue Region on the Diffusion of Glucose in Meniscus Fibrocartilage

Osteoarthritis (OA) is a significant socio-economic concern, affecting millions of individuals each year. Degeneration of the meniscus of the knee is often associated with OA, yet the relationship between the two is not well understood. As a nearly avascular tissue, the meniscus must rely on diffusive transport for nutritional supply to cells. Therefore, quantifying structure–function relations for transport properties in meniscus fibrocartilage is an important task. The purpose of the present study was to determine how mechanical loading, tissue anisotropy, and tissue region affect glucose diffusion in meniscus fibrocartilage. A one-dimensional (1D) diffusion experiment was used to measure the diffusion coefficient of glucose in porcine meniscus tissues. Results show that glucose diffusion is strain-dependent, decreasing significantly with increased levels of compression. It was also determined that glucose diffusion in meniscus tissues is anisotropic, with the diffusion coefficient in the circumferential direction being significantly higher than that in the axial direction. Finally, the effect of tissue region was not statistically significant, comparing axial diffusion in the central and horn regions of the tissue. This study is important for better understanding the transport and nutrition-related mechanisms of meniscal degeneration and related OA in the knee.

Cell viability in intervertebral disc under various nutritional and dynamic loading conditions: 3d finite element analysis

In this study, a new cell density model was developed and incorporated into the formulation of the mechano-electrochemical mixture theory to investigate the effects of deprivation of nutrition supply at boundary source, degeneration, and dynamic loading on the cell viability of intervertebral disc (IVD) using finite element methods. The deprivation of nutrition supply at boundary source was simulated by reduction in nutrition level at CEP and AF boundaries. Cases with 100%, 75%, 60%, 50% and 30% of normal nutrition level at both CEP and AF boundaries were modeled. Unconfined axial sinusoidal dynamic compressions with different combinations of amplitude (u=10%± 2.5%, ± 5%) and frequency (f=1, 10, 20 cycle/day) were applied. Degenerated IVD was modeled with altered material properties. Cell density decreased substantially with reduction of nutrition level at boundaries. Cell death was initiated primarily near the NP-AF interface on the mid-plane. Dynamic loading did not result in a change in the cell density in non-degenerated IVD, since glucose levels did not fall below the minimum value for cell survival; in degenerated IVDs, we found that increasing frequency and amplitude both resulted in higher cell density, because dynamic compression facilitates the diffusion of nutrients and thus increases the nutrition level around IVD cells. The novel computational model can be used to quantitatively predict both when and where cells start to die within the IVD under various kinds of nutritional and mechanical conditions.

Nutrient transport in human annulus fibrosus is affected by compressive strain and anisotropy

The avascular intervertebral disc (IVD) receives nutrition via transport from surrounding vasculature; poor nutrition is believed to be a main cause of disc degeneration. In this study, we investigated the effects of mechanical deformation and anisotropy on the transport of two important nutrients--oxygen and glucose--in human annulus fibrosus (AF). The diffusivities of oxygen and glucose were measured under three levels of uniaxial confined compression--0, 10, and 20%--and in three directions--axial, circumferential, and radial. The glucose partition coefficient was also measured at three compression levels. Results for glucose and oxygen diffusivity in AF ranged from 4.46 × 10(-7) to 9.77 × 10(-6) cm(2)/s and were comparable to previous studies; the glucose partition coefficient ranged from 0.71 to 0.82 and was also similar to previous results. Transport properties were found to decrease with increasing deformation, likely caused by fluid exudation during tissue compression and reduction in pore size. Furthermore, diffusivity in the radial direction was lower than in the axial or circumferential directions, indicating that nutrient transport in human AF is anisotropic. This behavior is likely a consequence of the layered structure and unique collagen architecture of AF tissue. These findings are important for better understanding nutritional supply in IVD and related disc degeneration.

3D finite element analysis of nutrient distributions and cell viability in the intervertebral disc: effects of deformation and degeneration

The intervertebral disc (IVD) receives important nutrients, such as glucose, from surrounding blood vessels. Poor nutritional supply is believed to play a key role in disc degeneration. Several investigators have presented finite element models of the IVD to investigate disc nutrition; however, none has predicted nutrient levels and cell viability in the disc with a realistic 3D geometry and tissue properties coupled to mechanical deformation. Understanding how degeneration and loading affect nutrition and cell viability is necessary for elucidating the mechanisms of disc degeneration and low back pain. The objective of this study was to analyze the effects of disc degeneration and static deformation on glucose distributions and cell viability in the IVD using finite element analysis. A realistic 3D finite element model of the IVD was developed based on mechano-electrochemical mixture theory. In the model, the cellular metabolic activities and viability were related to nutrient concentrations, and transport properties of nutrients were dependent on tissue deformation. The effects of disc degeneration and mechanical compression on glucose concentrations and cell density distributions in the IVD were investigated. To examine effects of disc degeneration, tissue properties were altered to reflect those of degenerated tissue, including reduced water content, fixed charge density, height, and endplate permeability. Two mechanical loading conditions were also investigated: a reference (undeformed) case and a 10% static deformation case. In general, nutrient levels decreased moving away from the nutritional supply at the disc periphery. Minimum glucose levels were at the interface between the nucleus and annulus regions of the disc. Deformation caused a 6.2% decrease in the minimum glucose concentration in the normal IVD, while degeneration resulted in an 80% decrease. Although cell density was not affected in the undeformed normal disc, there was a decrease in cell viability in the degenerated case, in which averaged cell density fell 11% compared with the normal case. This effect was further exacerbated by deformation of the degenerated IVD. Both deformation and disc degeneration altered the glucose distribution in the IVD. For the degenerated case, glucose levels fell below levels necessary for maintaining cell viability, and cell density decreased. This study provides important insight into nutrition-related mechanisms of disc degeneration. Moreover, our model may serve as a powerful tool in the development of new treatments for low back pain.

Effect of endplate calcification and mechanical deformation on the distribution of glucose in intervertebral disc: a 3D finite element study

The intervertebral disc (IVD) is avascular, receiving nutrition from surrounding vasculature. Theoretical modelling can supplement experimental results to understand nutrition to IVD more clearly. A new, 3D finite element model of the IVD was developed to investigate effects of endplate calcification and mechanical deformation on glucose distributions in IVD. The model included anatomical disc geometry, non-linear coupling of cellular metabolism with pH and oxygen concentration and strain-dependent properties of the extracellular matrix. Calcification was simulated by reducing endplate permeability (∼79%). Mechanical loading was applied based on in vivo disc deformation during the transition from supine to standing positions. Three static strain conditions were considered: supine, standing and weight-bearing standing. Minimum glucose concentrations decreased 45% with endplate calcification, whereas disc deformation led to a 4.8-63% decrease, depending on the endplate condition (i.e. normal vs. calcified). Furthermore, calcification more strongly affected glucose concentrations in the nucleus compared to the annulus fibrous region. This study provides important insight into nutrient distributions in IVD under mechanical deformation.

Relationship between solute transport properties and tissue morphology in human annulus fibrosus

Poor nutritional supply to the intervertebral disc is believed to be an important factor leading to disc degeneration. However, little is known regarding nutritional transport in human annulus fibrosus (AF) and its relation to tissue morphology. We hypothesized that solute diffusivity in human AF is anisotropic and inhomogeneous, and that transport behaviors are associated with tissue composition and structure. To test these hypotheses, we measured the direction-dependent diffusivity of a fluorescent molecule (fluorescein, 332 Da) in three regions of AF using a fluorescence recovery after photobleaching (FRAP) technique, and associated transport results to the regional variation in water content and collagen architecture in the tissue. Diffusivity in AF was anisotropic, with higher values in the axial direction than in the radial direction for all regions investigated. The values of the diffusion coefficient ranged from 0.38 +/- 0.25 x 10(-6) cm(2)/s (radial diffusivity in outer AF) to 2.68 +/- 0.84 x 10(-6) cm(2)/s (axial diffusivity in inner AF). In both directions, diffusivity decreased moving from inner to outer AF. Tissue structure was investigated using both scanning electron microscopy and environmental scanning electron microscopy. A unique arrangement of microtubes was found in human AF. Furthermore, we also found that the density of these microtubes varied moving from inner to outer AF. A similar trend of regional variation was found for water content, with the highest value also measured in inner AF. Therefore, we concluded that a relationship exists among the anisotropic and inhomogeneous diffusion in human AF and the structure and composition of the tissue.

Strain-dependent oxygen diffusivity in bovine annulus fibrosus

The intervertebral disk (IVD) is the largest avascular structure in the human body. Transport of small molecules in IVD is mainly through diffusion from the endplates and the peripheral blood vessels surrounding IVD. Studies have investigated the structure, chemical components, and water content in IVD, but to our knowledge no study has investigated the effect of mechanical loading on oxygen transport in IVD. The objective of this study was to determine the strain-dependent behavior of oxygen diffusivity in IVD tissue. A one-dimensional steady-state diffusion experiment was designed and performed to determine the oxygen diffusivity in bovine annulus fibrosus (AF). The oxygen diffusivity was calculated using equation derived from Fick's law. A total of 20 AF specimens (d=6 mm, h approximately 0.5 mm) from bovine coccygeal IVD were used to determine oxygen diffusivity at three levels of compressive strain. The average oxygen diffusivity (mean+/-SD) of bovine AF in the axial direction was 1.43+/-0.242 x 10(-5) cm(2)/s (n=20) at 4.68+/-1.67% compressive strain level, 1.05+/-0.282 x 10(-5) cm(2)/s (n=20) at 14.2+/-1.50% strain level, and 7.71+/-1.63 x 10(-6) cm(2)/s (n=20) at 23.7+/-1.34% strain level. There was a significant decrease in oxygen diffusivity with increasing level of compressive strain (ANOVA, p<0.05). Oxygen diffusivity of bovine AF in the axial direction has been determined. The mechanical loading has a significant effect on oxygen transport in IVD tissues. This study is important in understanding nutritional transport in IVD tissues and related disk degeneration.

A conductivity approach to measuring fixed charge density in intervertebral disc tissue

A new method for measuring the fixed charge density (FCD) in intervertebral disc (IVD) tissues employing a two-point electrical conductivity approach was developed. In this technique, the tissue is first confined and equilibrated in a potassium chloride (KCl) solution, and the tissue conductivity is then measured. This is then repeated with a second concentration of KCl solution. The FCD can be determined from the conductivity measurements. Using this method, the FCD values of bovine annulus fibrosus (AF) and nucleus pulposus (NP) tissues were determined to be 0.060 +/- 0.027 mEq/g wet tissue and 0.19 +/- 0.039 mEq/g wet tissue, respectively. The FCD of AF was significantly lower than that of NP tissue, similar to results in the literature for human IVD tissues. In order to verify the accuracy of the new method, the glycosaminoglycan (GAG) contents of the tissues were measured and used to estimate the tissue FCD. A strong correlation (R (2) = 0.84-0.87) was found to exist between FCD values measured and those estimated from GAG contents, indicating that the conductivity approach is a reliable technique for measuring the FCD of IVD tissues.

Effect of mechanical loading on electrical conductivity in human intervertebral disk

The intervertebral disk (IVD), characterized as a charged, hydrated soft tissue, is the largest avascular structure in the body. Mechanical loading to the disk results in electromechanical transduction phenomenon as well as altered transport properties. Electrical conductivity is a material property of tissue depending on ion concentrations and diffusivities, which are in turn functions of tissue composition and structure. The aim of this study was to investigate the effect of mechanical loading on electrical behavior in human IVD tissues. We hypothesized that electrical conductivity in human IVD is strain-dependent, due to change in tissue composition caused by compression, and inhomogeneous, due to tissue structure and composition. We also hypothesized that conductivity in human annulus fibrosus (AF) is anisotropic, due to the layered structure of the tissue. Three lumbar IVDs were harvested from three human spines. From each disk, four AF specimens were prepared in each of the three principal directions (axial, circumferential, and radial), and four axial nucleus pulposus (NP) specimens were prepared. Conductivity was determined using a four-wire sense-current method and a custom-designed apparatus by measuring the resistance across the sample. Resistance measurements were taken at three levels of compression (0%, 10%, and 20%). Scanning electron microscopy (SEM) images of the human AF tissue were obtained in order to correlate tissue structure with conductivity results. Increasing compressive strain significantly decreased conductivity for all groups (p<0.05, analysis of variance (ANOVA)). Additionally, specimen orientation significantly affected electrical conductivity in the AF tissue, with conductivity in the radial direction being significantly lower than that in the axial or circumferential directions at all levels of compressive strain (p<0.05, ANOVA). Finally, conductivity in the NP tissue was significantly higher than that in the AF tissue (p<0.05, ANOVA). SEM images of the AF tissues showed evidence of microtubes orientated in the axial and circumferential directions, but not in the radial direction. This may suggest a relationship between tissue morphology and the anisotropic behavior of conductivity in the AF. The results of this investigation demonstrate that electrical conductivity in human IVD is strain-dependent and inhomogeneous, and that conductivity in the human AF tissue is anisotropic (i.e., direction-dependent). This anisotropic behavior is correlated with tissue structure shown in SEM images. This study provides important information regarding the effects of mechanical loading on solute transport and electrical behavior in IVD tissues.

Effects of low glucose concentrations on oxygen consumption rates of intervertebral disc cells

STUDY DESIGN

Investigation of the effects of low glucose concentrations on the oxygen consumption rates of intervertebral disc cells.

OBJECTIVES

To determine the oxygen consumption rate of porcine anulus fibrosus (AF) cells at different glucose concentrations and to examine the differences in the oxygen consumption rate between AF and nucleus pulposus (NP) cells at different glucose levels.

SUMMARY OF BACKGROUND DATA

Poor nutrient supply has been suggested as a potential mechanism for degeneration of the intervertebral disc (IVD). Distribution of nutrients in the IVD is strongly dependent on transport properties of the tissue and cellular metabolic rates. Previous studies have shown dependence of oxygen consumption rate of IVD cells on oxygen tension, pH levels, and glucose levels outside the physiologic range. However, the oxygen consumption rate of AF cells at in vivo glucose levels has not been investigated.

METHODS

IVD cells were isolated from the outer AF and NP of 4- to 5-month-old porcine lumbar discs. The changes in oxygen tension were recorded when cells were cultured in sealed metabolism chamber. The oxygen consumption rate of cells was determined by theoretical curve fitting using the Michaelis-Menten equation.

RESULTS

The outer AF cells cultured in high glucose medium (25 mmol/L) exhibited the lowest oxygen consumption rate, whereas no significant differences in oxygen consumption rates were found among outer AF cells cultured at physiologic glucose levels (i.e., 1 mmol/L, 2.5 mmol/L, 5 mmol/L). The oxygen consumption rate of NP cells was significantly greater than that of outer AF cells.

CONCLUSION

Since the oxygen consumption rates determined in this study are comparable to the findings in the literature, this study has developed a new alternative method for determining oxygen consumption rate. The oxygen consumption rates of IVD cells reported in this study will be valuable for theoretically predicting local oxygen concentrations in IVD, which can provide a better understanding of transport of oxygen in the discs.

Pre-operative localization of breast microcalcification using high-frequency ultrasound

AIM

To determine whether high-frequency ultrasound (US) can be used to reliably localize breast microcalcification preoperatively in the absence of any associated mass lesion or distortion.

PATIENTS AND METHODS

Seventeen patients, found to have microcalcification at mammography, the majority screen detected, were studied using high-frequency (10 or 13 MHz) US to visualize the calcified particles. The approximate site of the microcalcifications was first determined from the mammograms. Once the calcifications had been localized, the skin overlying the site was marked with an indelible marker and the depth of the calcifications recorded for the surgeon. Successful excision of microcalcifications was confirmed with postbiopsy specimen X-ray.

RESULTS

Fifteen of the 17 patients (88%) underwent successful removal of the microcalcifications. The mean microcalcification cluster size was 160 mm with a mean number of calcifications of 20 at a mean depth of 15 mm. The mean size of the individual calcifications was 0.29 mm.

CONCLUSION

Our results show that high-frequency US is an effective non-invasive method of identifying and localizing breast microcalcification, and can be used as an alternative to hook wire stereotaxic localization in the majority of patients.

Characterization of cadherins expressed by murine thymocytes

Thymocytes develop in close apposition to the stromal cells of the thymus. The ontogeny of thymocytes is dependent on intimate interactions between these cells and the stromal cells. The molecular mechanisms involved in regulating thymocyte-stromal cell interactions remain to be clearly defined. In this study, we utilized a polymerase chain reaction strategy to identify members of the cadherin family of cell adhesion molecules that are expressed by CD4+ CD8+ thymocytes, the major cell type in the thymus. One classical cadherin (E-cadherin), three atypical cadherins (OB-cadherin) K-cadherin, and cadherin-8), and two novel cadherins (T1-cadherin and T2-cadherin) were found to be expressed by the CD4+ CD8+ thymocytes. The discovery that these cells display multiple cadherins opens a new area of investigation concerning the adhesive mechanisms involved in modulating thymocyte-stromal cell interactions. We speculate that cadherins will prove to play an essential role in the ontogeny of thymocytes.

Quality and interpretation of operative cholangiography in a district general hospital

The quality and interpretation of operative cholangiography were assessed in 128 patients undergoing cholecystectomy. The quality of each cholangiogram was assessed by calculating a cholangiogram score according to the anatomical structure visualized. Out of a maximum possible score of 5, 26% of cholangiograms achieved a score of less than or equal to 3 and were considered as technical failures. The sensitivity, specificity and negative predictive values regarding the surgeon's interpretation of the cholangiograms were high and compared well with the radiologist's assessment. However, the positive predictive value for the surgeon's assessment of the cholangiograms was 74% compared with 95% for the radiologist (P less than 0.02). Improvement in cholangiography can only be achieved by greater attention to detail and perseverance. After an adequate examination, the only criteria for common bile duct exploration should be the presence of filling defect(s).

A waiting time survey in general practice

Keeping patients waiting unnecessarily can be a cause of stress for both patient and doctor. Waiting time is a tangible aspect of your practice that patients will use to judge you, even more than your knowledge and skill. Determine your own actual waiting time, and see if you 'measure up'.

Small business, cash budgets and general practice

In practice management, general practice falls into the category of small business with all its attendant generic problems. Disciplined planning and good financial management are not often seen in small business. These are required if general practitioners are to continue (or return to) the provision of high quality medical services. An effective budget process, especially cash-flow budgeting, is the key to successful planning and financial management. Budgeting will bring Control, Co-ordination, and Credibility to your practice. It will enable you to set goals and to achieve them.

Nutritional myopathy in goats

A nutritional myopathy in unweaned fibre goats aged 2 to 4 mths is described in 3 flocks from the tablelands of New South Wales. Clinically affected animals were illthrifty and in circulatory failure prior to being found dead. At necropsy, there was pronounced ascites, pulmonary congestion and marked mottling of the liver. Chalky white streaks and patches were obvious in the myocardium, particularly in the right ventricular wall. Skeletal muscles varied from grossly normal to generally pale. Histologically, the myocardium exhibited areas of severe acute myonecrosis with mineralisation and adjoining areas of phagocytosis and fibrosis. In 2 of 3 flocks, some skeletal muscles showed a mild subacute myopathy. Marked hepatic congestion extended to periacinar haemorrhage and necrosis in some areas. Dietary imbalances of selenium, vitamin E and polyunsatured fatty acids were probable factors in the pathogenesis of the condition.

How to assess the business performance of your practice

The objective of this article is to provide motivation and practical guidance to those general practitioners who wish to assess the performance of their practice in the business and financial sense, but who believe that they lack the necessary training and resources.

BCG emulsion immunotherapy of equine sarcoid

Of 61 horses with sarcoids treated with intralesional injection of a double emulsion incorporating inactivated bacillus Calmette Guérin organisms, 36 (59 per cent) showed complete regression and 11 (18 per cent) showed partial regression. The majority of cases required only one treatment. Not all sarcoids were responsive to this therapy; those not responding were usually large or on horses with multiple sarcoids.

Oral toxicity of a bloom of the Cyanobacterium microcystis Aeruginosa administered to mice over periods up to 1 year

Cyanobacterial blooms in lakes have been reported causing livestock deaths and liver injury to human populations. In this study bloom material consisting of Microcystis aeruginosa was collected from a farm water storage after the death of sheep drinking from it. The cyanobacterial cells were lysed and a cell-free extract was provided to mice at a series of dilutions as their only source of drinking water. Mice of both sexes, with controls, were killed at intervals up to 1 yr of administration. Autopsies, histopathological examination, and analyses of plasma lactate dehydrogenase and alanine aminotransferase were carried out. Increased mortality was observed, particularly among males, together with chronic active liver injury and elevated alanine aminotransferase in blood. In control mice and those receiving lower concentrations of extract, hepatic amyloidosis with neutrophil infiltration, and bronchopneumonia, were seen with increasing age. The bronchopneumonia appeared earlier among mice receiving cyanobacterial extract. Four tumors were seen in 71 mice receiving a high concentration of extract for up to 1 yr, none in 150 mice receiving lower concentrations, and 2 in 73 control mice. No effects on male or female fertility, embryonic mortality, neonatal viability, or skeletal development were observed, but 7 out of 73 neonatal mice born to parents given cyanobacterial extract showed reduced brain size. No cases were seen in controls. We conclude that the major toxicity exhibited is liver injury. Further attention is needed for evaluation of carcinogenicity and embryonic damage.

Toxicity of the cyanobacterium Nodularia spumigena Mertens

The bloom forming cyanobacterium (blue-green alga) Nodularia spumigena produced a peptide hepatotoxin with an LD50 of 70 micrograms/kg i.p. in mice. The livers of lethally poisoned mice were haemorrhagic and enlarged, the weight doubling to about 10% of total body weight. Histologically there was centrilobular to midzonal disruption and lysis of hepatocytes resulting in haemorrhage and formation of blood lakes. Death occurred approximately 1 hr after i.p. injection. By 30 min significant increases had occurred in the plasma levels of lactate dehydrogenase, aspartate aminotransferase, alanine aminotransferase and glucose paralleling degeneration and necrosis of centrilobular hepatocytes. In vitro the toxin caused rapid dose-dependent deformation of freshly isolated rat hepatocytes, which was accompanied by the activation of phosphorylase a; 125 ng/ml of toxin being sufficient to cause these changes in 10(6) cells. This work demonstrates that, both in vivo and in vitro, Nodularia toxin shares many similarities in its action to the well characterized peptide toxins of another cyanobacterium, Microcystis aeruginosa.

Toxicity to mice and sheep of a bloom of the cyanobacterium (blue-green alga) Anabaena circinalis

A bloom of Anabaena circinalis shown to be lethal to mice (i.p. LD50 17.0 +/- 0.6 mg/kg) was tested for lethal potency when given orally to mice and intraruminally and intraperitoneally to sheep. The lethal oral dose in mice was at least 170 times the parenteral dose. The bloom was lethal when given i.p. to sheep but lethality was not observed when given intraruminally in doses up to 1710 mg/kg, equivalent to drinking 8.5 litres of thick algal bloom, a volume far in excess of that likely to be consumed naturally. In vivo testing of lethal potency by i.p. inoculation of mice is therefore an unreliable method for judging potential oral toxicity in livestock of blooms of Anabaena.

Kikuyu poisoning of cattle in New South Wales and its relationship to pasture fungi on kikuyu grass (Pennisetum clandestinum)

In the late summer and autumn of 1980 kikuyu poisoning of cattle was diagnosed on 9 farms in New South Wales resulting in 213 deaths among 1370 cattle at risk. Clinical, autopsy and histopathological findings are described and are consistent with those previously recorded. Kikuyu grass samples from 5 paddocks in which deaths were occurring were examined for the presence of fungi. Myrothecium spp were not present. Fusarium semitectum, F. moniliforme var subglutinans, Penicillium spp and a Phoma sp were the most common fungi isolated but with the exception of F. semitectum were not consistently present. F. semitectum was present in adjacent kikuyu grass paddocks in which deaths were not occurring. Two of the farms had army caterpillar (Mythimna convecta) infestations. Army caterpillar faeces present in these paddocks did not contain Myrothecium spp; the fungi present reflected the population present on the kikuyu grass. These findings do not suggest a mycotic cause for kikuyu poisoning.

Lethal potency and tissue distribution of 125I-labelled toxic peptides from the blue-green alga Microcystis aeruginosa

Toxic heptapeptides from a water bloom of the cyanobacterium Microcystis aeruginosa were purified by HPLC. The unoxidised fraction was iodinated with 125I plus 127I by the lactoperoxidase/H2O2 method, further purified by HPLC, and the non-iodinated and three iodinated fractions administered i.p. to male mice. All iodinated fractions were toxic, with symptoms and pathological lesions of the liver identical with those caused by non-iodinated peptide. Radioactivity was concentrated in the liver of mice at death.

Severe hepatotoxicity caused by the tropical cyanobacterium (blue-green alga) Cylindrospermopsis raciborskii (Woloszynska) Seenaya and Subba Raju isolated from a domestic water supply reservoir

Cylindrospermopsis raciborskii, a tropical blooming species of cyanobacterium (blue-green alga), was isolated from the domestic water supply reservoir on Palm Island, a continental island off the tropical northeast coast of Australia. This species, not previously known to be toxic, was shown to be severely hepatotoxic for mice. The 50% lethal dose at 24 h after injection was found to be 64 +/- 5 mg of freeze-dried culture per kg of mouse. The principal lesion produced was centrilobular to massive hepatocyte necrosis, but various degrees of injury were also seen in the kidneys, adrenal glands, lungs, and intestine. The possible implication of this finding in relation to an incident of hepatoenteritis in humans living on the island is discussed.